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Elbow Dislocations

RebelEM

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (..)

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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

Ben has a possible skull fracture and has been intubated, but his oxygen requirement is minimal. A 2012 study on paediatric patients showed that approximately 42% were intubated without medications, and 2% were intubated with paralysis only in the ED. Pediatric Emergency Care 28(11): p 1129-1131, November 2012. |

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Trauma Resuscitation Updates

RebelEM

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. NEJM 1994. [2]

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

RebelEM

Given AHA guidelines recommend early epinephrine administration in cardiac arrest, obtaining access is imperative for resuscitative efforts ( 9) When evaluating over 300,000 out-of-hospital cardiac arrests, a meta-analysis found no significant change in primary outcomes when IV and IO access were compared ( 10 ). 2012 PMID: 21893125.

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SGEM386: Blood on Blood – Massive Transfusion Protocols in Older Trauma Patients

The Skeptics' Guide to EM

EMS have already splinted an obvious mid-shaft femoral fracture, but he continues to be tachycardic and hypotensive. Background: Major trauma in older patients is increasing in frequency (1), with the median age of major trauma patients in the UK from 2012-2017 being 63.6 years ( 2 ).

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Pediatric Elbow Injuries

Pediatric Emergency Playbook

Pediatric Elbow Films: Putting It All Together Watch this dynamic video by Dr Jeremy Jone s from Radiopaedia : Fracture Saviors: Fat Pads and Drawn Lines These three things can save us: fat pads, the anterior humeral line, and the radiocapitellar line. If not, assume a fracture-dislocation.

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SGEM#264: Hooked On A Feeling? Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain

The Skeptics' Guide to EM

Case: You are taking care of a 56-year-old woman who presented to the emergency department with a Jones fracture. Pain 2012). ACEP has a clinical policy regarding prescribing of opioids for adult ED patients that was published in 2012 ( Cantrill et al ). Corey Heitz is an emergency physician in Roanoke, Virginia.