RebelEM

AUGUST 30, 2023

Most common organism is Staph Aureus (36-67% of cases) ( Boody 2015 ). Executive Summary: 2015 Infectious Disease Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults. Clin Infect Dis 2015 Sept 15;61(6):859-63. Other pathogens include: E.

Infectious Diseases 100

Infectious Diseases Fractures Radiology Radiology 100

EMDocs

MARCH 2, 2024

A 3 cm scalp laceration is noted, and a CT scan of the head shows a linear nondepressed skull fracture in the area of the laceration without evidence of intracranial hemorrhage. This is considered an open fracture. Patients with open skull fractures should be evaluated by neurosurgery and admitted for observation.

EMS 119

EMS Fractures Seizures Head Injuries 119

RebelEM

MAY 25, 2023

JAMA 2015 [7] The PROPPR Trial 680 severely injured adult trauma patients Patients randomized to Plasma, Platelets, and PRBCs in a 1:1:1 ratio vs 1:1:2 ratio No difference in overall mortality at 24 hrs BUT 1:1:1 achieved hemostasis faster and fewer experienced death due to exsanguination at 24hrs Crombie N et al. Lancet 2019.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

ALiEM

DECEMBER 22, 2023

The patient reported a history of falls resulting in shoulder, rib, and left hip fractures in the past. Occult femur fracture Occult fractures are defined as fractures that cannot be detected by standard radiographic examination until weeks after the injury either due to lack of displacement or limitations of the imaging study.

Fractures 64

Fractures Dislocations Academics Radiology 64

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). 2015 PMID: 25768683 8 Leidel BA. This can often lead to significant delays in proper resuscitation. Trauma 1996.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Sensible Medicine

OCTOBER 21, 2024

Some things will surely hold up: PCI for MI, fixing displaced fractures, antibiotics for bacterial infection, and of course, caring and empathy. But they also observed that 9 of 48 patients died in the lorcainide group vs only 1 of 47 in the placebo arm. They did not expect this 9-fold higher death rate.

Evidence-Based Practice 111

Evidence-Based Practice Shock Fractures Outcomes 111

Northwestern EM Blog

MARCH 1, 2025

Absolute contraindications of prone positioning are severely increased intracranial pressure as positioning of the head in prone position can partially obstruct cerebral venous drainage, as well as unstable spinal fractures because the manipulation while repositioning a patient may lead to further injury (Guerin et. 2020; Koulouras et.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

Taming the SRU

JULY 25, 2024

Indication - skeletally mature patients with a radiographically documented femur fracture (hip to knee) Contraindications: Patient refusal Allergy to local anesthetic Infection over site of planned injection Obtunded/uncooperative patient Crush injury No available provider or space Medication: 0.5%

Stroke 98

Stroke Fractures Operations Outcomes 98

EMDocs

JUNE 28, 2023

” This is especially true with hip fractures in the elderly. August 31, 2015) “Relationships between nurses and physicians matter” OJIN: The Online Journal of Issues in Nursing Vol. One must always ascertain the exact cause of the “slip and fall.” a stroke or cardiac event). References : 1. Siedlecki, S.,

Documentation/Coding 95

Documentation/Coding EMS Stroke Patient Safety 95

RebelEM

JANUARY 24, 2024

2015; 3(4): PMID: 26665055 Post Peer Reviewed By: Salim R. You will notice the squeeze will cause no motion if there is a full rupture/tear, and diminished motion if there is a partial tear Performance Characteristics ( Garras 2012 ) Sensitivity Specificity (+) LR (-) LR 96-100% 93-100% 13.7 J Bone Joint Surg Br 2011; 93(10):1362-6.

Operations 101

Operations Ultrasounds Fractures Outcomes 101

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%. Orthop Traumatol Surg Res 2015; 101: pp. Published 2015 Jul 29. Pro-inflammatory states may also play a role, as patients with CRPS have significantly higher levels of plasma cytokines and chemokines. Audouin-Pajot C.,

Psychiatric 98

Psychiatric Pediatrics Outcomes Fractures 98

Pediatric Emergency Playbook

NOVEMBER 1, 2016

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.

Pediatrics 52

Pediatrics Fractures Dislocations Radiology 52

The Skeptics' Guide to EM

DECEMBER 17, 2022

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

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 52

Taming the SRU

AUGUST 30, 2023

A 2015 prospective, cross-sectional study of 78 Thai patients published in the International Journal of Rheumatic Disease demonstrated a sensitivity of 59% and specificity of 84% for PCT with a cut-off of 0.5 2015 Mar;18(3):352-9. They recommended synovial fluid analysis as essential to the diagnosis [30]. Int J Rheum Dis. 2018.09.070.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

PHEM Cast

JULY 27, 2021

2015 Marik PE, Cavallazzi R. Kenji Inaba.

Ultrasounds 52

Ultrasounds Fractures Resuscitation EMS 52

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 40

Fractures Emergency Department Resuscitation Research 40

EM Guide Wire

MAY 19, 2019

2015; 135 (5): e1337-e1354. 2015; 136(5): 831-838. Delayed Identification of Pediatric Abuse-Related Fractures. The Evaluation of Suspected Child Abuse. PEDIATRICS. Glick JC, Lorand MA, and Bilka KR. Physical Abuse of Children. Pediatrics in Review. 2016; 37(4): 146-158. Lindberg DM, Beaty B, Juarez-Colunga E, et al. PEDIATRICS.

Pediatrics 40

Pediatrics Soft Tissue Injuries Fractures Emergency Nursing 40

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Trauma CTs showed a "mildly displaced sternal fracture and a small retrosternal hematoma." 2015, March 1). It is very unlikely that a previously healthy teenager would have such disease of the conduction system, bringing up the possibility of blunt cardiac injury in this clinical setting. Myocardial contusion in an 8-year-old boy.

EKG/ECG 115

EKG/ECG Wellness Fractures Emergency Department 115

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]. 2015, www.reviewofoptometry.com/article/practical-pearls-for-managing-anterior-uveitis. High risk of re-bleeding and vision loss [7]. EyeWiki , EyeWiki, 13 Nov.

EMS 98

EMS Allergic Reactions Poisoning Emergency Department 98

ALiEM

OCTOBER 30, 2024

A trans-esophageal echocardiogram showed a normal ejection fracture, normal right ventricular function, and no vegetations. 2015 Apr 28;313(16):1636-44. Evaluation for nephrotic syndrome due to viral hepatitis, endocarditis, venous thromboembolism or other cause of chronic lymphedema is reasonable.

Emergency Department 64

Emergency Department Operations Psychiatric EMS 64

RebelEM

JANUARY 29, 2024

JACCC Cardiovasc Interv 2015. in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 A prospective, Single-Arm Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study. PMID: 26315743 Tapson VF et al.

Stroke 136

Stroke Outcomes Hospitals Administration 136

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. J Trauma Acute Care Surg 2015 Apr;78(4):721-8 4. Norii, Crandall, Terasaka. Brenner et al.

Hospitals 52

Hospitals Resuscitation Shock Military 52

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? Check out this video at the new CORE EM website regarding the tongue blade test to assist with your decision making. Or maybe just want to reminisce on the great time you had at the conference?

EMS 52

EMS Ultrasounds EKG/ECG Fractures 52

PHEM Cast

JULY 14, 2016

An injury involving only the anterior column is considered to be stable, as will an isolated fracture of a spinous or transverse process. Elsevier Ltd; 2015 Apr 1;46(4):528–35. 2015 May;78(5):943–8. Posterior column: facet joints, ligamentum flavum, the spinous processes and the interconnecting ligaments. N Engl J Med.

Fractures 52

Fractures Hospitals Shock Research 52

The Skeptics' Guide to EM

DECEMBER 8, 2017

Physician frustrations with managing acute non-traumatic low back pain include considering rare dangerous back pain patient (epidural abscesses, osteomyelitis, pathological fractures, etc), patients demanding imaging, difficulty in relieving pain and concern about opiate abuse or diversion. The conclusions…we need more evidence.

Emergency Department 52

Emergency Department Fractures EMS 52

PEMBlog

JUNE 5, 2024

2015 Apr;22(4):441-6. Epub 2015 Mar 16. 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. Acad Emerg Med.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

RebelEM

MARCH 9, 2023

Assess for blood in the nares or signs of basal skull fracture, including battle signs, raccoon eyes, or hemotympanum. Check that clavicles are intact and that there are no obvious rib fractures or spinal step-offs. Epub 2015 Sep 14. Any facial or scalp lacerations, abrasions, ecchymosis, or deformities should prompt imaging.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

Don't Forget the Bubbles

SEPTEMBER 30, 2024

conducted over three years (2013-2015) in Florida, found that younger children and those arriving in the evening or overnight had higher rates of “Did Not Wait” cases. Gaucher et al. found that children arriving in the evening and those aged between 3 months and 11 years were likelier to leave without being seen.

Emergency Department 89

Emergency Department Research Pediatrics Hospitals 89

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). 2015 Feb;78(2):295–9. J Emerg Med. 2010 Oct;39(4):468–75. Intraosseous infusion rates under high pressure.

Emergency Department 92

Emergency Department Ultrasounds Administration Burns 92

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. 2015 Jan;50(1):177-81. 2015 Oct 19. The second impact happens as the child is flung onto the grill or the hood of the car, causing usually thoracic trauma.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

The Skeptics' Guide to EM

JULY 2, 2017

She takes the oral contraceptive pill and was placed in a below-knee plaster cast for a fibula fracture 2 weeks ago. The 2015 Chest Guidelines recommend systemically administered thrombolytic therapy in patients with acute PE associated with hypotension (systolic BP<90mmHg) who do not have a high risk of bleeding ( Kearon et al 2016). *

Fractures 40

Fractures Emergency Department Ultrasounds Outcomes 40

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

All deaths involving hip fractures if the attending physician believes the fracture caused or contributed to the cause of death. If the fracture is to appear anywhere on the death certificate, the certificate must be completed by the Department of Medical Examiner-Coroner and not by the attending physician. · 2003 Revision.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Northwestern EM Blog

DECEMBER 20, 2021

Physical examination should always include an attempt to ambulate the child unless there is an obvious contraindication noted immediately (eg open fracture). 2015 Nov 15;92(10):908-16. If the child refuses to bear weight, the child should be made non-weight bearing until serious pathology which can be worsened by walking is ruled out.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Taming the SRU

MARCH 14, 2023

Obtain shunt imaging (“shunt series,” CTH non-con) Shunt series shows no migration of the shunt catheters or fractures of the tubing. You read about the patient’s history of VP shunt placement for aqueductal stenosis as a child and decide to order some imaging… What are you going to order? Lancet Neurol. Marmarou, Young, Aygok.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

EB Medicine

MARCH 1, 2019

In terms of radiography, a chest x-ray should be obtained as rib fractures, hemopneumothorax, and mediastinal free air are all things you wouldn't want to miss and are also associated with blunt cardiac injury. Nachi: The 2015 EAST guidelines conditionally recommend ED thoracotomy for moribund patients with signs of life.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 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 98

EMS Dislocations Fractures Operations 98

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. Life in the Fast Lane. Accessed 2/2/2016. McNamara, Paul.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40