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Elbow Dislocations

RebelEM

2009 Mar;17(3):137-51. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30480959 Mathew PK, Athwal GS, King GJ. Terrible triad injury of the elbow: current concepts. J Am Acad Orthop Surg. Doi: 10.5435/00124635-200903000-00003. PMID: 19264707 Murphy KA, Morrisonponce D. Anatomy, Shoulder and Upper Limb, Median Nerve. 2023 Aug 20.

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Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

RebelEM

What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021. Outcomes: Primary Outcome: Reduction of dyspnea measured on a verbal dyspnea scale (VDS) from 0 to 10 recorded at enrollment, then at 2, 4, and 5 hours after arrival.

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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

A retrospective cohort analysis of the ED portion of the National Hospital Ambulatory Medical Care Survey from 2006 to 2009 in the US revealed that less than one-half of patients undergoing ETI in the ED received sedative drugs while in the ED. When there is an immediate threat to life (e.g., What are the potential physiological sequelae?

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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. Ong MEH, Chan YH, Oh JJ, et al.

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Subcutaneous Insulin for Diabetic Ketoacidosis

ACEP Now

In 2009, a consensus statement from the American Diabetes Association (ADA) discussed using a low-dose infusion (0.1 Evaluation of outcomes following hospital-wide implementation of a subcutaneous insulin protocol for diabetic ketoacidosis. units/kg/hour) rather than a bolus. Rao P, Jiang SF, Kipnis P, et al. JAMA Netw Open.

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Ultrasound of the Month: No Definitive Yolk Sac, No Definitive IUP!

Taming the SRU

At this point, the patient is taken to the operating room for a diagnostic laparoscopy. Discrimination between an IUP and an interstitial pregnancy is critical as interstitial pregnancies can have devastating outcomes. She was taken to the operating room and found to have a right tubal ectopic pregnancy with a pseudogestational sac.

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SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind?

The Skeptics' Guide to EM

Huber-Wagner et al ( Lancet 2009 ) showed a mortality reduction in a retrospective database study of patients who have had a pan scan. There is no validated clinical decision tool to help guide our decisions. Many studies (most retrospective) have assessed the use of pan scanning as an initial radiologic evaluation. Reference: Sierink et al.