Pediatric EM Morsels

JULY 7, 2023

Evaluating the limping child , though, requires us to ponder not only the common (ex, Toddler’s Fracture ), but also to be vigilant for the severe (ex, Septic Arthritis ). Cunningham, 2018 ] Account for less than 1% of all knee injuries. Epub 2018 Apr 19. Cunningham NJ, Farebrother N, Miles J. Emerg Med Australas.

Dislocations 141

Dislocations Fractures Pediatrics EMS 141

EB Medicine

JUNE 1, 2018

Join hosts Jeff Nusbaum, MD, and Nachi Gupta, MD on this episode of EMplify as they take you through the June 2018 issue of Emergency Medicine Practice: Managing Shoulder Injuries in the Emergency Department Fracture, Dislocation, and Overuse. Displaced proximal humeral fractures: part I. Cochrane Database Syst Rev.

Dislocations 40

Dislocations Emergency Department Fractures Research 40

EMDocs

MARCH 30, 2024

3,4 Risk factors include engaging in high energy activities, consumption of large amounts of alcohol, osteoporosis, and previous thoracic or lumbar fractures. 10 Spinal Fracture Classification 11 There are multiple different classification systems available. Spine fracture. The spinal canal houses the spinal cord. J Emerg Med.

EMS 89

EMS Fractures Emergency Department Dislocations 89

Dr. Smith's ECG Blog

AUGUST 18, 2024

The patient was found to have a fractured lead, which was replaced successfully without complications and with resolution of symptoms. No P wave and no QRS ever follows any of the regular pacing spikes ( a result of the fractured pacing lead ). He did well. Smith: this can usually be seen on chest x-ray.

EKG/ECG 96

EKG/ECG Fractures Burns Wellness 96

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

Ultrasound Gel

JULY 8, 2019

In October 2018, an all-star group met during the Irish Association for Emergency Medicine annual conference to talk about point-of-care ultrasound. In part 1 of 2, the group talks about the landmark original SHoC-ED trial and performing the erector spinae plane block for rib fractures.

Fractures 52

Fractures Ultrasounds 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Background During closed reduction of displaced distal radius fractures, physical examination is used to determine the need for further manipulation before radiographic confirmation and cast application. In total, 105 patients were randomised to standard treatment and 106 patients to PoCUS-guided fracture reduction. to 6.45).

Fractures 40

Fractures Ultrasounds Emergency Department Operations 40

EMDocs

AUGUST 28, 2023

Chuck Pilcher, MD, FACEP Editor, Medical Malpractice Insights Failure to detect child abuse results in $45 million verdict Femur fracture missed; no imaging follow-up system in place Facts : A 2 ½ month old infant is brought to the ED by his mother because he is not moving his right leg and cries every time it is touched.

Fractures 64

Fractures Seizures Patient Safety Hospitals 64

Don't Forget the Bubbles

JUNE 30, 2023

She has a right parietal-occipital region haematoma, and you think you might be able to feel a step – you’re pretty convinced she has a palpable skull fracture. published in 2018, looked at 1900 matched pairs of injured children under 12, half of whom received TXA. 2018 Dec;19(12):e637-e642. Pediatr Crit Care Med.

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

The Skeptics' Guide to EM

MARCH 15, 2019

Ann Emerg Med 2018. Ann Emerg Med 2018. Date: March 12th, 2019 Reference: Gottlieb, Holladay and Peksa. Ultrasonography for the Confirmation of Endotracheal Tube Intubation: A Systematic Review and Meta-Analysis. He hosts a great #FOAMed blog and podcast called TOTAL EM. Date: March 12th, 2019 Reference: Gottlieb, Holladay and Peksa.

Ultrasounds 52

Ultrasounds Fractures EMS Hospitals 52

Taming the SRU

JANUARY 10, 2024

Additionally, ED boarding is a now a larger factor than in 2018. Physicians believe the biggest factors contributing to ED violence are a lack of adequate punitive consequences toward the attacker and the absence of adequate protective mechanisms for staff.

EKG/ECG 92

EKG/ECG Shock Fractures Emergency Department 92

The Skeptics' Guide to EM

JULY 17, 2018

[display_podcast] Date: July 16th, 2018 Reference: Gupta M et al. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. display_podcast] Date: July 16th, 2018 Reference: Gupta M et al. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Pediatrics 52

Pediatrics Head Injuries Academics Emergency Department 52

The Skeptics' Guide to EM

OCTOBER 6, 2018

[display_podcast] Date: October 5th , 2018 Reference: Stiell et al. Annals of EM Oct 2018 Guest Skeptic: Alison Armstrong is an Emergency Department Nurse, TNCC Course Director, Trauma Program Coordinator and Canadian C-Spine Rule Nurse Champion. display_podcast] Date: October 5th , 2018 Reference: Stiell et al.

Emergency Department 52

Emergency Department EMS Fractures 52

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

Don't Forget the Bubbles

DECEMBER 25, 2023

In the BUCKLED trial that looked at whether ultrasound was non-inferior to X-ray in diagnosing forearm fractures, the primary outcome was physical function of the affected arm at four weeks. doi:10.1136/bmjebm-2018-110891 Perkins GD, Ji C, Deakin CD, et al. They are the variables that matter most to the patient. We love POOs.

Research 83

Research Outcomes Fractures Pediatrics 83

Don't Forget the Bubbles

DECEMBER 2, 2024

The interventions were based on GINA guidelines 2018 and performed over a 5-month period. This may lead to either missing potential fractures or overcall injuries, leading to increased use of hospital resources and increased morbidity. Single-center cohort studies showed suboptimal accuracy in correctly identifying elbow injuries.

Documentation/Coding 98

Documentation/Coding Pediatrics Emergency Department Fractures 98

PEMBlog

OCTOBER 18, 2024

Orthopedic Risks: Watch for Fat Embolism DMD patients are prone to fat embolisms following fractures due to the fatty infiltration of their bone marrow. Any trauma that results in fractures should raise immediate concern for fat embolism syndrome, which can present rapidly and lead to respiratory and cardiovascular complications.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Trauma CTs showed a "mildly displaced sternal fracture and a small retrosternal hematoma." 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. 1520: The QRS has narrowed slightly, but the morphology is similar.

EKG/ECG 112

EKG/ECG Wellness Fractures Emergency Department 112

ALiEM

FEBRUARY 28, 2024

This blog post provides an update to our 2018 blog articles to reflect these changes. Both bone forearm fracture with dorsal displacement AP. We also must recognize the important contributions of media such as clinical photographs, radiology images, and ECGs. Video Publications Last Name First Initial. Video Title. Publication Title.

Radiology 52

Radiology Radiology Academics Fractures 52

Sensible Medicine

NOVEMBER 21, 2023

Like Dr. Järvinen’s piece on the prevention of fractures in older people published here a couple of weeks ago, his submission highlights how difficult it can be to express opinions that challenge mainstream thinking these days. Jonasson lecture given by Joan Reede MD at the ACS Clinical Congress in 2018.

Leadership 107

Leadership Fractures Wellness 107

EMDocs

OCTOBER 9, 2023

12 Weight gain (up to 70%), development of cataracts (up to 15%), fractures (up to 12%), and neuropsychiatric events (up to 10%) are the most common adverse events. Consider the other complications of systemic steroids: weight gain, cataracts, fractures, and neuropsychiatric events. October 19, 2018. Published 2017 Oct 12.

Basic Life Support 81

Basic Life Support CPR Fractures Emergency Department 81

Dr. Smith's ECG Blog

APRIL 18, 2024

The ECG is just a test: a Bayesian approach to acute coronary occlusion If a patient with a recent femur fracture has sudden onset of pleuritic chest pain, shortness of breath, and hemoptysis, the D-dimer doesn’t matter: the patient’s pre-test likelihood for PE is so high that they need a CT. But does this matter?

EKG/ECG 121

EKG/ECG Documentation/Coding Fractures Emergency Department 121

EMDocs

DECEMBER 19, 2023

link] Published December 30, 2018. Possible early antibiotic treatment Minor Marine Trauma Mechanism: Bites, Stings, Nematocysts Envenomation Presentation: All can cause localized pain, erythema, and warmth Dermatologic: Urticaria, burning, pruritus, localized paresthesia. Goldfrank’s Toxicologic Emergencies, 11e. McGraw Hill; 2019.

Poisoning 90

Poisoning Seizures Anaphylaxis Burns 90

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 78

Administration Fractures Anaphylaxis Head Injuries 78

RCEM Learning

NOVEMBER 28, 2022

Introduction Immediate management Control of haemorrhage Use of pelvic binder REBOA Management of stable VS unstable fracture Management of closed VS open fracture Other injuries Immediate management Coordinated and structured approach (eg. Learning bite Nearly 90% of pelvic fracture bleeding is venous in origin.

Fractures 40

Fractures Blood Transfusions Sepsis Operations 40

Taming the SRU

NOVEMBER 27, 2023

Before definitive management, X-rays of the affected finger should be considered, especially in cases where there is suspicion for a foreign body or clinical concern for associated fracture, osteomyelitis, or necrotizing soft tissue infection [17]. Similar to complex paronychias, treatment of most felons relies on incision and drainage.

Soft Tissue Injuries 93

Soft Tissue Injuries Emergency Department EMS Fractures 93

RebelEM

JANUARY 29, 2024

JACC Cardiovasc Interv 2018. in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 A Randomized Trial of the Optimum Duration of Acoustic Pulse Thrombolysis Procedure in Acute Intermediate-Reisk Pulmonary Embolism: The OPTALYSE PE Trial. PMID: 30025734 Sharifi M et al. Am J Cardiol 2013. PMID: 23102885 Aykan AC et al.

Stroke 130

Stroke Outcomes Hospitals Administration 130

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

EMDocs

JUNE 25, 2024

Most common traumatic injuries are fractures, TBIs, and thoracic or abdominal injuries. National Burn Repository 2019 Update, Report of data from 2009–2018. Immediate goals are addressing the airway and hemodynamic instability. Always consider trauma and toxic exposure in the burn patient. References American Burn Association.

Burns 72

Burns Fluid Resuscitation Resuscitation Poisoning 72

Taming the SRU

FEBRUARY 5, 2024

Pay close attention to the head and cervical spine for evidence of injuries that necessitate imaging, such as midline spinal tenderness and/or signs of basilar skull fracture (Table 3). TABLE 2: Symptoms of concussion A thorough physical exam should be performed, focusing on evidence of traumatic injuries and sequela of concussion.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

Advanced Emergency Nursing from AENJ

MARCH 26, 2018

Blog 2018 – 3. Whether distracting the patient with a fractured hip (in the absence of any analgesia) from noticing the notorious potholes and railway tracks over which we were compelled to drive; or engaging the trust and defusing the hostility of a victim's friends demanding to know why we hadn't gotten there sooner to take care of him.

Emergency Nursing 40

Emergency Nursing Fractures Pediatrics 40

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. Elsevier; 2018. Updated 2018 Dec 16]. This is usually caused by blunt trauma and is most commonly seen in wrestlers, mixed martial artists, or boxers. Seventh edition. Stat Pearls.

Emergency Department 92

Emergency Department Pediatrics Wellness Documentation/Coding 92

Taming the SRU

AUGUST 30, 2023

A 2018 USA multi-center prospective RCT involving 1,656 adult patients published in NEJM used varying PCT cut-offs to guide antibiotic initiation in the emergency department. 2018 Aug 1;10(8):a028456. Epub 2018 Oct 19. Identifying serious causes of back pain: cancer, infection, fracture. 2018 Jul 31;138(5):e78-e79.

Infectious Diseases 87

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

PEMBlog

JUNE 5, 2024

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. Axial load can cause burst fracture, so someone that dives into a pool.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

RebelEM

MARCH 9, 2023

Klein 2018) Despite the high risk of pathology and decompensation, many patients with presumed alcohol intoxication can be evaluated and discharged without any labs or imaging. Assess for blood in the nares or signs of basal skull fracture, including battle signs, raccoon eyes, or hemotympanum. 2018 Mar;71(3):279-288.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

EMDocs

NOVEMBER 6, 2024

tetani infection is also indicated. tetani infection is also indicated.

Poisoning 76

Poisoning Airway Management Dislocations Forensics 76

Dr. Smith's ECG Blog

AUGUST 17, 2022

She had some fractures. For review — GO TO: The June 4, 2018 post ( LA-LL reversal ). The July 29, 2018 post ( LA-RA reversal ). The November 4, 2018 post ( Leads V1,V2 misplacement ). In this case, the ischemia is NOT OMI; it only mimics OMI because of the atrial fib. The February 11, 2020 post ( LA-RA reversal ).

EKG/ECG 52

EKG/ECG Fractures 52