Taming the SRU

MAY 22, 2023

Ankle fractures are the third most common fracture in the ED [2] and more than 20,000 patients are seen in the ED for ankle sprains each day [3]. traumatic axial loading with calcaneal fractures, pilons, and vertebral compression fractures) [5]. Gross deformities often suggest fracture or dislocation [Image 2].

Fractures 76

Fractures Dislocations Operations Radiology 76

Taming the SRU

OCTOBER 28, 2024

Potential causes include: -Trauma: Blunt or penetrating thoracic injuries, rib fractures, esophageal rupture (Boerhaave syndrome). When should I get a consultant involved in the emergency department? 2015 Feb;7(Suppl 1):S44-9. 2015 May;166(5):1317-1317.e1. West J Emerg Med. 2015 Mar;16(2):321-4.

COPD 78

COPD Pediatrics Emergency Department Ultrasounds 78

RebelEM

APRIL 29, 2024

In these situations, the American Heart Association (AHA) and the European Resuscitation Council (ERC) of 2015 recommend the intraosseous (IO) route after the peripheral route and before the central venous route ( 1). World J Emerg Surg 2023 PMID: 36918947 3. Int J Emerg Med 2009 PMID: 20157465 4. Ong MEH, Chan YH, Oh JJ, et al.

Resuscitation 105

Resuscitation Administration Emergency Department Hospitals 105

Mind The Bleep

SEPTEMBER 17, 2024

Introduction Patients regularly present to the emergency department with animal bites. 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.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

The Skeptics' Guide to EM

DECEMBER 17, 2022

Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. EMS have already splinted an obvious mid-shaft femoral fracture, but he continues to be tachycardic and hypotensive.

Blood Transfusions 52

Blood Transfusions Fractures EMS Hospitals 52

EMDocs

JUNE 8, 2024

Orbital wall fractures: palpate bony structures surrounding the eye, check extra ocular muscle movements to rule out entrapment, obtain CT imaging if suspected [7]. A 32-year-old man presents to the emergency department with eye pain. Overview of Eye Injuries in the Emergency Department.” UpToDate , 30 Oct.

EMS 80

EMS Allergic Reactions Poisoning Emergency Department 80

EB Medicine

MARCH 1, 2019

This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. Nachi: The 2015 EAST guidelines conditionally recommend ED thoracotomy for moribund patients with signs of life. Ann Emerg Med. Nachi: Definitely.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

Taming the SRU

AUGUST 30, 2023

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. They recommended synovial fluid analysis as essential to the diagnosis [30].

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

EB Medicine

NOVEMBER 1, 2018

But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. Thankfully, fatalities are declining, with just 565 in 2015. Jeff: You’re right.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EMDocs

JUNE 3, 2023

How should pelvic fractures be identified in unstable trauma patients? Pelvic fractures can involve disruptions in any of the bony or ligamentous structures of the pelvic ring. Due to the round shape of the pelvic ring, multiple fractures typically occur concurrently. 2 Vertical shear fractures are also unstable.

Fractures 54

Fractures Resuscitation Operations EMS 54

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Barr 2016 , Trevejo-Nunez 2015) Patients are at high risk of bleeding from the GI tract due to clotting factor impairment or devastating hemorrhage from esophageal varices in the setting of portal hypertension.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

PEMBlog

JUNE 5, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

EM Guide Wire

MAY 19, 2019

2015; 135 (5): e1337-e1354. 2015; 136(5): 831-838. Delayed Identification of Pediatric Abuse-Related Fractures. Parents’ Opinions About a Routine Head-to-Toe Examination of Children as a Screening Instrument for Child Abuse and Neglect in Children Visiting the Emergency Department. PEDIATRICS. PEDIATRICS.

Pediatrics 40

Pediatrics Soft Tissue Injuries Fractures Emergency Nursing 40

Taming the SRU

SEPTEMBER 1, 2023

2015) reported a sensitivity of 98.9% for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al.,

Sepsis 94

Sepsis Documentation/Coding Administration Fractures 94

ETM Course

JUNE 17, 2015

In this episode we talk to Joseph Mathew, one of the authors of a great new article on a novel technique for tamponade of bleeding related to pelvic fractures. We also cover the oft-misunderstood procedure of retrograde urethrogram (RUG). This is a great locally written article and I’d recommend you check it out!

Fractures 52

Fractures Emergency Department Resuscitation Research 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. Trauma CTs showed a "mildly displaced sternal fracture and a small retrosternal hematoma." 2015, March 1). He was intubated for altered mental status.

EKG/ECG 107

EKG/ECG Wellness Fractures Hospitals 107

Taming the SRU

MARCH 14, 2023

Case 1 Fussy 1 month old A 1-month-old (ex-34 week premature) infant comes to your emergency department for fussiness. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. More on this below as we work through a few cases….

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

EMDocs

NOVEMBER 6, 2024

doi:10.1136/bcr-2015-213897 Paterson AW, Ryan W, Rao-Mudigonda VV. He denies any past medical history other than polysubstance abuse and depression. tetani infection is also indicated. 1992;359(6398):832-835. doi:10.1038/359832a0 Giannini L, Maccari A, Chiesa V, Canevini MP. Trismus, the first symptom in a challenging diagnosis of Tetanus.

Poisoning 77

Poisoning Airway Management Dislocations Forensics 77

EM Curious

JULY 1, 2015

ER Cast Part 1 Part 2 SMACC-stalgia SMACC CHICAGO 2015 PEARLS [PODCAST]: Missed SMACC Chicago and want to hear what all the buzz was about? LITERATURE THAT MAY INTEREST YOU [JOURNALS]: Should we be looking for and treating isolated calf vein thrombosis? Or maybe just want to reminisce on the great time you had at the conference?

EMS 52

EMS Ultrasounds EKG/ECG Fractures 52

The Skeptics' Guide to EM

JULY 2, 2017

Case: A 22-year-old patient presents to the emergency department with sudden onset shortness of breath. She takes the oral contraceptive pill and was placed in a below-knee plaster cast for a fibula fracture 2 weeks ago. Kirsty is also the creator of a knowledge translation project called #PaperinaPic.

Fractures 40

Fractures Outcomes Emergency Department Ultrasounds 40

Northwestern EM Blog

DECEMBER 20, 2021

Written by: Tommy Ng, MD (NUEM ‘24) Edited by: Patricia Bigach, MD (NUEM ‘22) Expert review by : Terese Whipple, MD '20 So your kid won’t walk One of the most common complaints in a pediatric Emergency Department is a child refusing or inability to ambulate. 2015 Nov 15;92(10):908-16. 2012;97(5):185-193. Am Fam Physician.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Depending on the height of the child and the height of the car, the initial impact will cause a femur fracture, a pelvic fracture, or direct abdominal trauma. Pediatric emergency department thoracotomy: a large case series and systematic review. 2015 Jan;50(1):177-81. 2015 Oct 19. J Pediatr Surg. J Surg Res.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

EMDocs

NOVEMBER 16, 2024

6 Periprosthetic fracture Occurs at an estimated rate of 3.5-4.1%. 5 CT if concern for occult fracture. Periprosthetic Fractures Pain prior to injury may point toward underlying pathology like infection, implant loosening, etc. Unified classification system used to describe periprosthetic hip fractures. 10% of patients.

EMS 75

EMS Dislocations Fractures Operations 75

Pediatric Emergency Playbook

JANUARY 1, 2017

Some are simple comfort measures such as splinting (fracture or sprain), applying cold (acute soft tissue injury) or heat (non-traumatic, non-specific pain), or other targeted non-pharmacology. Long-bone injuries Fracture pain should be addressed immediately with splinting and analgesia. Acad Emerg Med. Pediatr Emerg Care.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

Act V, scene I [Text from Folger Shakespeare Library] [Audio recording of Dramatic Reading; Chapter Vox] [Video recording of Act V, scene1] Most deaths that are brought to, or occur in, an emergency department will require, at least, discussion with the local Coroner or Medical Examiner. Published January 15, 2015.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

ALiEM

OCTOBER 30, 2024

A trans-esophageal echocardiogram showed a normal ejection fracture, normal right ventricular function, and no vegetations. Bupe Allergy Buprenorphine induction has been the mainstay of emergency department treatment of opioid use disorder for more than a decade [11, 12]. 2015 Apr 28;313(16):1636-44. 2017 Jun;32:660-6.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

EB Medicine

JUNE 6, 2019

Jeff: Abdominal pain is the one of most frequent complaint in US emergency departments, representing 8% of all adult ED visits, with admission rates for all patients with abdominal pain ranging between 18-42% and reaching as high as 60% for the elderly. Emerg Med Clin North Am. Nachi: This is another really important point.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Don't Forget the Bubbles

SEPTEMBER 23, 2024

You are working in the paediatric emergency department of a busy District General Hospital. These centres have a close relationship with their patients, but this does not mean they may not turn up at your emergency department! Kidney transplant recipients have a higher risk of fractures. Any history of injury?

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Northwestern EM Blog

JANUARY 3, 2022

climbing stairs) Diagnosis: Anterior patella tenderness; pain with patellar grind test , deep knee flexion EM differential: meniscus injury, stress fracture, ligamentous injury Initial treatment: home exercise program or formal physical therapy to strengthen quadriceps, core, and hip abductors.

Fractures 52

Fractures EMS Urgent Care Stroke 52

EMDocs

MAY 29, 2023

Louis); Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case A 54-year-old female with a past medical history of rheumatoid arthritis presents to the emergency department (ED) with generalized fatigue. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2015 Nov. Epub 2015 Jul 29.

Infectious Diseases 53

Infectious Diseases Emergency Department EMS Hospitals 53

RebelEM

MAY 22, 2023

For instance, while pain resulting from extremity fractures and dislocations can often be relieved after reduction and splinting, abdominal pain poses a more elusive and complex scenario involving multiple contributing factors. The quality of emergency department pain care for older adult patients. 2010;58(11):2122-2128.

Administration 97

Administration Emergency Department Dislocations Outcomes 97

Taming the SRU

FEBRUARY 22, 2023

Paske et al.

Hospice 40

Hospice EKG/ECG Wellness Resuscitation 40

EMDocs

JULY 3, 2023

Louis); Alex Koyfman, MD (@EMHighAK); Marina Boushra, MD (EM-CCM Attending, Cleveland Clinic Foundation) Case A 62-year-old male with past medical history of hypertension (HTN), hyperlipidemia (HLD), and prior cerebrovascular accident (CVA) presents to the emergency department (ED) via ambulance. 2015 Dec;23 Suppl 2(Suppl 2):S76-82.

Seizures 85

Seizures Stroke Outcomes EMS 85

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. 23 Blunt vertebral artery injury has been found to be associated with older age, female sex, lower GCS, presence of neck pain, cervical spine fracture, and blunt carotid injury.

Stroke 86

Stroke Radiology Radiology Emergency Department 86