RebelEM

FEBRUARY 24, 2025

RESUS SCENARIO Picture this: you just arrived at your shift at the local emergency department. just be careful with pelvic fractures or any femoral arterial punctures/ devices. Nov 2020; PMID: 33140173 Hanson J, et al. For more than just the correctness of terminology, the distensibility index should then be calculated.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

PEMBlog

OCTOBER 18, 2024

Duchenne Muscular Dystrophy (DMD) is a complex and progressive disease requiring highly specialized care, especially in emergency situations. When patients with DMD present in the Emergency Department (ED), an understanding of the nuanced aspects of their care is essential for optimal management. 2020 Jun 5;15(1):141.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 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

The Skeptics' Guide to EM

MARCH 27, 2021

He currently serves as Vice-Chair of the Danish Society for Emergency Medicine and Chair of the Young Doctors in Emergency Medicine in Denmark. Date: March 17th, 2021 Guest Skeptic: Dr. Emil Ejersbo Iversen is an emergency medicine resident at the University Hospital of Zealand, Denmark. J Trauma Acute Care Surg.

Fractures 40

Fractures Outcomes Hospitals Emergency Department 40

Taming the SRU

JANUARY 10, 2024

89% agree that violence in the emergency department has harmed patient care. None of the physicians in the study believe that the rate of violence has decreased at all. Additionally, ED boarding is a now a larger factor than in 2018.

EKG/ECG 93

EKG/ECG Shock Fractures Dislocations 93

RebelEM

APRIL 29, 2024

World J Emerg Surg 2023 PMID: 36918947 3. Intraosseous vascular access in adults using the EZ-IO in an emergency department. Int J Emerg Med 2009 PMID: 20157465 4. Comparison of intraosseous versus central venous vascular access in adults under resuscitation in the emergency department with inaccessible peripheral veins.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

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.” McGraw Hill, 2020.

EMS 96

EMS Allergic Reactions Poisoning Emergency Department 96

Taming the SRU

OCTOBER 1, 2023

This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department. Blunt trauma can cause rib fracture or dislocation that may injure the visceral pleura. Published 2020 Jul 23. Ann Emerg Med. Clin Pract Cases Emerg Med.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Mind The Bleep

NOVEMBER 6, 2023

In this injury, there is a fracture of the orbital floor and the inferior orbital rim remains intact. The “teardrop sign” is a radiological sign of inferior orbital wall fractures in which intraorbital fat +/- inferior rectus muscle herniates through the fracture. Teardrop sign (inferior orbital wall fracture).

Fractures 52

Fractures Radiology Radiology Emergency Department 52

Taming the SRU

NOVEMBER 14, 2023

Chief complaints involving the ear are a common occurrence in Emergency Departments across the US and include presenting symptoms such as ear pain or fullness, hearing loss, redness, trauma, vertigo, and foreign bodies. A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. I sent this to the Queen of Hearts So the ECG is both STEMI negative and has no subtle diagnostic signs of occlusion.

EKG/ECG 122

EKG/ECG Documentation/Coding Fractures Emergency Department 122

Taming the SRU

FEBRUARY 5, 2024

Traumatic brain injury (TBI) accounts for millions of Emergency Department visits annually. While moderate and severe TBI is often managed on an inpatient basis, patients presenting with mild TBI, or concussion, are often managed solely by Emergency physicians.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

Taming the SRU

JANUARY 29, 2024

She was concerned that this was not improving and decided to come to the emergency department (ED). 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 2020 Nov 25. Phlebology.

Emergency Department 94

Emergency Department Fractures Hospitals Operations 94

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. However, these observations have failed to be validated at a larger level and should be taken with caution.

Infectious Diseases 89

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

ACEP Now

MAY 6, 2023

Case A 35-year-old male is brought to the emergency department (ED) following a single-motor-vehicle collision in which two people were ejected and pronounced dead at the scene. million ED visits for injuries from motor vehicle accidents (MVAs) in 2020. He is completely amnestic to the events of the accident. Click to enlarge.)

Forensics 52

Forensics Documentation/Coding Fractures Head Injuries 52

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

RebelEM

JANUARY 30, 2023

PSA, also referred to as intravenous sedation in this paper, requires considerable resources, including 1:1 nursing observation, and burdens the emergency department (ED). Canadian Journal of Emergency medicine. Paper: Sithamparapillai A, Grewal K, Thompson C, Walsh C, McLeod S. vs. 91.4%; RR 0.93; 95% CI 0.86–1.01,

Dislocations 58

Dislocations Emergency Department Outcomes Research 58

Mind The Bleep

NOVEMBER 6, 2023

Importance: the medial wall is thin and most easily fractured. Sight Threatening Conditions in the Emergency Department Open globe injury Key signs without needing a slit lamp: Prolapse of intraocular contents (e.g. Accessed 11.10.22 < [link] > Gardiner (2022) Overview of eye injuries in the emergency department.

Emergency Department 52

Emergency Department Dislocations Burns Fractures 52

PEMBlog

SEPTEMBER 13, 2023

battle sign bruises around the mastoid, raccoon eyes, or other bruising and lacerations) or reported by history – but could be identified (later) with a bleed or fracture on a head CT scan if your index of suspicion is high or the seizure is going well beyond the expected duration and not responding well to antiepileptics.

Seizures 52

Seizures Pediatrics Point-of-Care Testing Wellness 52

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 94

EMS Dislocations Fractures Operations 94

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]. Microdosing Methods Help, 2020. 2017 Jun;32:660-6.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

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 60

Fractures Resuscitation Operations EMS 60

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

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. 2020 Sep 29;95(13):e1819-e1829.

Seizures 98

Seizures Stroke Outcomes EMS 98

Don't Forget the Bubbles

JULY 22, 2024

There is an increased risk of pneumonia and sepsis in the 31-90 days after prescription and an increased risk of fractures, GI bleeds and sub-optimal growth. A Randomized Trial of Single-Dose Oral Dexamethasone Versus Multidose Prednisolone for Acute Exacerbations of Asthma in Children Who Attend the Emergency Department.

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

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. 2020 Jan 1;153(1):14-29. Identifying serious causes of back pain: cancer, infection, fracture.

Infectious Diseases 55

Infectious Diseases Emergency Department EMS Hospitals 55

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. J Emerg Med. Acad Emerg Med.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

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 103

Stroke Radiology Radiology Emergency Department 103

Don't Forget the Bubbles

JULY 17, 2023

Original clinical studies Distribution and pattern of hand fractures in children and adolescents. 2023 Jun 1;76(6):731-736 The Association Between Media-Based Exposure to Nonsuicidal Self-Injury and Emergency Department Visits for Self-Harm. Trends in Reasons for Human Papillomavirus Vaccine Hesitancy: 2010-2020.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

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 77

Fractures Dislocations Operations Radiology 77

EMDocs

SEPTEMBER 9, 2023

The value of ultrasound for detecting hand fractures: A meta-analysis. 2021.0052 Emergency Department Management of Extensor Tendon Lacerations – Page 3 of 4. Ann Emerg Med. Open Fracture. Emergency Medicine Residents’ Association; 2022:10-11. Extensor tendon repair in the emergency department.

EMS 97

EMS Fractures Soft Tissue Injuries Ultrasounds 97

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

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

EMDocs

NOVEMBER 6, 2024

2020-0841 Lin TS, Chen LK, Lin TY, Wen SH, Chen MC, Jan RH. He denies any past medical history other than polysubstance abuse and depression. tetani infection is also indicated. 2002;122(4):1488-1492. doi:10.1378/chest.122.4.1488 122.4.1488 Li L, Liu Z. 2021;21(1):e103-e105. doi:10.7861/clinmed.2020-0841 Pediatr Neonatol. 2011;52(3):169-171.

Poisoning 95

Poisoning Airway Management Dislocations Hyperthermia / Hypothermia 95