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Rebaked Morsel: Pediatric Buckle and Greenstick Forearm Fractures

Pediatric EM Morsels

Plint, 2006. No formal follow up was scheduled Outcomes were: effectiveness, parental satisfaction, and economic benefits The majority of children wore their braces as directed (94%)There was no re-fractureAll parents were happy with the treatment (100%) and felt comfortable removing the brace (100%). West, 2005.

Fractures 290
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The Modified Valsalva Maneuver: Practical Treatment or Pointless Trick?

RebelEM

The primary outcomes are patient-centered and objectively measured, potentially ensuring relevance and reliability. The unblinded nature of the study could influence outcomes due to observer bias. Employing P-values to compare demographics between groups could mislead interpretations of the data’s relevance to the primary outcomes.

Outcomes 137
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Glasgow Coma Scale in Children

Pediatric EM Morsels

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. 2006 May;34(5):379-87.

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Perichondritis of the Ear in Children

Pediatric EM Morsels

Infections there become complicated very quickly and the outcomes can be very poor. 2006 Dec;22(12):804-6. Inpatient Vs Outpatient Therapy No standard approach… but… here is what I say: “ Always Fear Infections in the Hands, Feet, or Face.” ” Those areas have very important and delicate structures.

Burns 130
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Intensive blood glucose control in the ICU is not helpful (TGC-FAST trial)

PulmCCM

Hyperglycemia is associated with worse outcomes in the ICU (and in medical patients generally), so correcting it must improve outcomes … right?

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EM@3AM: Leukopenia

EMDocs

0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. Philadelphia, PA: Mosby; 2006:384-418. An update on the diagnosis and treatment of chronic idiopathic neutropenia. Curr Opin Hematol. 2017;24(1):46-53. doi:10.1097/MOH.0000000000000305 J Blood Disord Transfus. Gedefie, A.,

EMS 96
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SGEM#409: Same as it Ever Was – Tamiflu for Influenza?

The Skeptics' Guide to EM

The Cochrane collaboration published analyses of the available data in 1999, 2003 and 2006. Safety issues popped up soon after widespread use of the drug including neuropsychiatric effects as well as the more common adverse effects of nausea and vomiting. There was a large unblinded RCT of over 3,000 patients published in the Lancet in 2020.

CDC 108