EM Curious

JULY 24, 2015

It's a bit of a departure from what we've described above--he mainly goes right at a shaft fracture--but it's the same general idea: As always, these posts are for EDUCATIONAL PURPOSES ONLY. Ultrasound-Guided Three-In-One Nerve Block for Femur Fractures. Academic Emergency Medicine, 20(6), 584–591. doi:10.1111/acem.12154 doi:10.1111/j.1742-6723.2009.01163.xdoi:10.1097/PEC.0000000000000101

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

Taming the SRU

JANUARY 1, 2024

Contraindications to placing an IO include a prior attempt at the same site, known orthopedic fracture or local hardware, overlying skin infection, and structural bone disease such as osteogenesis imperfecta (6). 2010 Oct;39(4):468–75. 2010 Sep 1;134(9):1253–60. Int J Emerg Med. 2009 Sep 11;2(3):155–60. Intraosseous Access.

Emergency Department 93

Emergency Department Ultrasounds Administration Burns 93

Don't Forget the Bubbles

AUGUST 2, 2023

We know that fractures are the precipitating event in about 5–14% of cases and surgical procedures in 10–15%. Several neurological mechanisms for CRPS have been suggested, including central sensitisation, alteration in the central nervous system (CNS), and small fibre changes. 2013;14(2):180-229. doi:10.1111/pme.12033 12033 Harden, R.

Psychiatric 98

Psychiatric Pediatrics Outcomes Academics 98

ETM Course

JUNE 28, 2015

Intra-Aortic Balloon Occlusion to Salvage Patients with Life-Threatening Hemorrhagic Shocks from Pelvic Fractures J Trauma 2010; 68(4): 942–8 (full article free text) 3. 2011 Dec;71(6):1869-72 (full article free text) 2. Martinelli et al. Norii, Crandall, Terasaka.

Hospitals 52

Hospitals Resuscitation Shock Military 52

Taming the SRU

FEBRUARY 12, 2024

CT HEAD Bilateral hemorrhagic contusions, left subdural hematoma with mass effect, scattered subarachnoid hemorrhage, occipital bone fracture and venous thrombosis adjacent to fracture site. Notable diagnostics Point-of-care glucose (initial): 274 PT/INR: 47.4/4.9 BMC Pharmacol Toxicol. May 2; 19(1): 19. Schulman, S et al.

Administration 81

Administration Fractures Anaphylaxis Head Injuries 81

RebelEM

MARCH 9, 2023

Pompili 2010) However, >65% of patients who endorse suicidal ideation when intoxicated no longer endorse suicidal ideation once sober. Assess for blood in the nares or signs of basal skull fracture, including battle signs, raccoon eyes, or hemotympanum. 2010 Apr;7(4):1392-431. Epub 2010 Mar 29.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

Broome Docs

APRIL 6, 2023

Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK. 2010 Oct 5;182(14):1527-32. Epub 2010 Aug 23. 2022 Jul 2;400(10345):39-47. doi: 10.1016/S0140-6736(22)01015-7. doi: 10.1503/cmaj.091974. Justin’s Full critical appraisal can be found here.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Taming the SRU

JANUARY 29, 2024

Notable Diagnostics CBC : unremarkable, BMP : unremarkable X-ray imaging of the left hand, wrist, and forearm: chronic degenerative changes without acute fracture or bony abnormality. Epub 2010 Feb 6. The remainder of the physical examination is unremarkable. Di Nisio M, Van Sluis GL, Bossuyt PM, Büller HR, Porreca E, Rutjes AW.

Emergency Department 95

Emergency Department Fractures Hospitals Operations 95

Taming the SRU

NOVEMBER 14, 2023

A thorough trauma history and physical exam should be performed including evaluation for bony fracture in the surrounding structures of the face. 2010 Dec;26(6):451-5. This is usually caused by blunt trauma and is most commonly seen in wrestlers, mixed martial artists, or boxers. A) on LEFT: Auricular hematoma with overlying tattoos.

Emergency Department 95

Emergency Department Pediatrics Wellness Fractures 95

Taming the SRU

AUGUST 30, 2023

Critical Care Medicine 38():p S26-S34, February 2010. | Identifying serious causes of back pain: cancer, infection, fracture. N Engl J Med. 2023 Feb 2;388(5):439-452. doi: 10.1056/NEJMra2206346. PMID: 36724330; PMCID: PMC9912245. Levi, Marcel MD, PhD; van der Poll, Tom MD, PhD. Inflammation and coagulation. DOI: 10.1097/CCM.0b013e3181c98d21

Infectious Diseases 90

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 90

Taming the SRU

OCTOBER 1, 2023

Blunt trauma can cause rib fracture or dislocation that may injure the visceral pleura. PPV, rib fractures, and decreased GCS were predictive of conservative management failure [23]. Carries the advantage of being able to detect displaced rib fractures, foreign bodies, mediastinal or diaphragmatic changes [17]. J Emerg Med.

Fractures 97

Fractures COPD Hospitals Emergency Department 97

RebelEM

MAY 22, 2023

In 2010, the United States Food and Drug Administration (FDA) granted approval for intravenous (IV) acetaminophen as a pain management option. Background: The geriatric patient population is at high risk for undertreatment of pain (Hwang et al. Likewise, there are many important considerations when prescribing analgesics in this group.

Emergency Department 90

Emergency Department Administration Dislocations Hospitals 90

RebelEM

MAY 25, 2023

Pelvic Fracture A score ≥2 present, consider MTP Clinical Take Home Point: Use of balanced transfusion (including PRBCs and clotting factors) helps avoid dilutional coagulopathy WHOLE BLOOD VS COMPONENT THERAPY Kronstedt S et al. 2010; 376(9734):23-32. Lancet (London, England). PMID: 20554319 The CRASH-3 Trial Collaborators.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

PEMBlog

JUNE 5, 2024

Epub 2010 Oct 29. The most common injuries seen in these younger patients are growth plate fractures and ligamentous injuries. You more often will see vertebral body and arch fractures as opposed to the growth plate fractures and ligamentous injuries in the younger children. Ann Emerg Med. 2011 Aug;58(2):145-55.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

RebelEM

JANUARY 29, 2024

CHEST 2010. in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 Efficacy and Safety of Low Dose Recombinant Tissue-Type Plasminogen Activator for the Treatment of Acute Pulmonary Thromboemolism: A Randomized, Multicenter Controlled Trial. PMID: 19741062 Kucher N et al. Circ 2014.

Stroke 136

Stroke Outcomes Hospitals Administration 136

Pediatric Emergency Playbook

MARCH 1, 2016

He sustained a femur fracture, splenic laceration, and blunt head trauma – the so-called Waddell’s triad. Rib fractures on CXR predict pulmonary contusions. 2010 Nov;19(4):286-91. A 5-year-old boy was playing with his older brother in front of their home when he was struck by a car. He decompensates and needs blood. 2010.07.002.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

In fact, one of my surgeon grandfather's ortho buddies (perhaps with the help of some lunchtime martinis) took a look at the x-rays of my Boxer's Fracture and snapped it back into place without any analgesia or procedural sedation, casted me, and sent me home. Still no pain medicine. Elsevier Health Sciences. Amazon.com link. Nickson, Chris.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

EMDocs

NOVEMBER 4, 2024

Costochondritis, rib fractures, and pericarditis are common causes of chest pain that can be treated with multimodal regimens. 7 Rib and Sternal Fractures: Rib fractures are often caused by blunt chest trauma. Up to two-thirds of rib fractures are missed on initial chest radiographs. Most cases abate by one year.

Emergency Department 106

Emergency Department Fractures Burns EMS 106

Pediatric Emergency Playbook

JANUARY 1, 2017

Assessing and managing children’s pain can be challenging, because they may not exhibit typically recognized signs and symptoms ( Srouji 2010 ). The Baker-Wong FACES Pain Rating scale ( Figure 1 ) was developed with feedback from children and has been validated for use in those 3 years of age and older ( Keck 1996 , Tomlinson 2010 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

MAY 29, 2023

Identifying serious causes of back pain: cancer, infection, fracture. Epub 2010 Jul 22. Clin Infect Dis. 2015 Sep 15;61(6):e26-46. doi: 10.1093/cid/civ482. Epub 2015 Jul 29. PMID: 26229122. (12) 12) Siemionow K, Steinmetz M, Bell G, Ilaslan H, McLain RF. Cleveland Clinic journal of medicine. 2008;75(8):557-566. doi:10.3949/ccjm.75.8.557

Infectious Diseases 57

Infectious Diseases Emergency Department EMS Hospitals 57

EMDocs

NOVEMBER 13, 2023

23 Blunt carotid injury is more likely in patients with at least one of the following: Glasgow Coma Scale (GCS) ≤ 6, fracture of petrous bone, presence of diffuse axonal brain injury, and LeFort II/III fractures. 23 BCVI should be suspected with any high-energy trauma or any fractures of the maxilla or mandible. 24) Kelts, G.;

Stroke 105

Stroke Radiology Radiology Emergency Department 105

RebelEM

DECEMBER 18, 2024

2010, (Ch) 70: p 895-909. Philadelphia: Mosby Elsevier, 2010. Anterior dislocations: palpation of the TMJ can reveal one or both of the condyles to be anteriorly displaced in front of the articular eminence. Louis, Mosby, Inc., GorchynskiJ et al. J Emerg Med. 2014; 47(6):676-81. PMID 25278137 Marx JA et al. Mendez DR et al.

Dislocations 52

Dislocations Fractures Operations EMS 52

Mind The Bleep

JANUARY 24, 2025

Upper limb fractures and dislocations can lead to associated arterial and nerve damage. First aid such as irrigation, tourniquet use, reduction and splinting of fractures/dislocations. Fracture reduction and immobilisation : Fracture and/or dislocation reduction can restore alignment and vascular supply as well as reduce pain.

Dislocations 52

Dislocations Fractures Soft Tissue Injuries Infectious Diseases 52

Pediatric Education

APRIL 6, 2025

Other conditions to consider instead of JFM include inflammatory conditions (juvenile idiopathic arthritis), thyroid disease, inflammatory bowel disease, hypermobility, unrecognized fracture or soft tissue problem, Raynaud’s disease, myopathies and others. Treatment is multidisciplinary. 2016;169:181-7.e1. doi:10.1016/j.jpeds.2015.10.011

Pediatrics 40

Pediatrics Psychiatric Academics Fractures 40

Don't Forget the Bubbles

JULY 17, 2023

Original clinical studies Distribution and pattern of hand fractures in children and adolescents. Trends in Reasons for Human Papillomavirus Vaccine Hesitancy: 2010-2020. Ultrasonography or Radiography for Suspected Pediatric Distal Forearm Fractures. Strategies for Managing Impairing Emotional Outbursts. McClellan JM, et al.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

Dr. Smith's ECG Blog

JANUARY 21, 2023

CT head showed traumatic SAH and small SDH with a traumatic occipital fracture. Heart Rhythm 2010 Hudzik B, Gasior M. Although there were "no signs of trauma on scene or on the patient" — Head CT revealed an occipital fracture, with traumatic SAH and a small SDH. Electrolytes and an extended electrolytes panel were normal.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Many authors feel NTI is absolutely or relatively contraindicated with potential basilar skull fractures; there is also opinion arguing that airway protection trumps the extreme rarity of this complication. Intracranial placement of a nasotracheal tube after facial fracture: a rare complication. Sinusitis can occur in long intubation.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40

Mind The Bleep

SEPTEMBER 17, 2024

Feel: Palpate the area of the bite to feel for areas of tenderness as this could indicate a fracture or infection. There should be a minimum of 2 views in the plain film, or 3 in the hands if there is a suspicion of a fracture. Comorbidities Diabetes and immunosuppression increase infection risk and severity 11. Regular medications.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52