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). Management is orthopedic consultation for operative stabilization [12]. 2021, Dec 20). Strength and range of motion of both lower extremities should also be examined [2].

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. Ultimately, definitive management is in the operating room with revision or replacement of the VP shunt. CTH demonstrates acute hydrocephalus despite the presence of a VP shunt. Neurol Med Chir (Tokyo).

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Pediatric EM Morsels

APRIL 28, 2023

We have previously discussed how the surrounding ligaments and tendon are often stronger than the weakest part of the child’s bone necessitating our vigilance when addressing the pediatric extremity complaint (ex, Ankle Pain , Elbow Injury , Supracondylar Fractures ). Of course, we cannot assume all anterior knee pain is benign.

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Fractures Pediatrics Operations Wellness 130

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 57

Fractures Resuscitation Operations EMS 57

Taming the SRU

JANUARY 29, 2024

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. 2021 Oct;76:601.e7-601.e11. Epub 2021 Jun 25. 2021 Jun;36(5):392-400. The remainder of the physical examination is unremarkable.

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Emergency Department Fractures Hospitals Operations 93

EMDocs

SEPTEMBER 9, 2023

McGraw Hill; 2021. The value of ultrasound for detecting hand fractures: A meta-analysis. Rosh Review Website Link References Park CW, Juliano ML, Woodhall D. Tendon Lacerations. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e. Accessed June 24, 2023. link] Dy CJ, Rosenblatt L, Lee SK. doi:10.1097/MD.0000000000017823

EMS 90

EMS Fractures Soft Tissue Injuries Ultrasounds 90

EMDocs

AUGUST 12, 2023

Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement. Inoculation usually occurs by penetrating injury , which seeds the tendon sheath. Unrecognized or persistent infection can lead to necrosis of the tendon. There are no extensor tendon sheaths (A) in the hand.

EMS 81

EMS Fractures Operations Ultrasounds 81

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. Sci Rep 11, 1767 (2021). Regular medications. Assess neurovascular status distal to the bite.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

PHEM Cast

SEPTEMBER 14, 2022

secondary to fire or other hazard) These principles have been adopted by national level stakeholders in the UK are being incorporated into national clinical and operational guidance which will reduce entrapment time and may demonstrate morbidity and mortality reductions. Scand J Trauma Resusc Emerg Medicine 29 , 17 (2021). Nutbeam, T.

Fractures 52

Fractures Operations Outcomes Academics 52

Don't Forget the Bubbles

AUGUST 10, 2023

This is partly because the hands (including fingers) of children & young people have a tendency to fracture without as much compressive force being applied to the bones when compared with adult hands. The resulting injuries include crush injuries, fractures, avulsions, lacerations and amputations. No bone is exposed.

Fractures 52

Fractures Soft Tissue Injuries Emergency Department Operations 52

Taming the SRU

AUGUST 30, 2023

This finding was not significantly different among operators with different levels of experience, or between adults and children. 2021; 93: 4358–4369. 2021 Jan;25(1):466-479. Identifying serious causes of back pain: cancer, infection, fracture. Epub 2021 Oct 1. J Med Virol. Medicine (Baltimore). doi: 10.1097/MD.0000000000023315.

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

EMDocs

NOVEMBER 16, 2024

4 Pain is the most common reason for presentation in the early post operative period. 5 Highest risk of dislocation early in the post operative course due to laxity of the soft tissue after surgery. 6 Hip flexion or adduction in the early post-operative period can cause atraumatic dislocations (typically avoided for 6 weeks post-op).

EMS 88

EMS Dislocations Fractures Operations 88

ALiEM

OCTOBER 30, 2024

A trans-esophageal echocardiogram showed a normal ejection fracture, normal right ventricular function, and no vegetations. Your patient ultimately is diagnosed with a spinal epidural abscess requiring operative care. 2021 Aug 1;94:103086. Clinical impact: The patient’s DVT ultrasounds were negative. 2023;29(6):470-476.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

Don't Forget the Bubbles

SEPTEMBER 23, 2024

Kidney transplant recipients have a higher risk of fractures. suprapubic catheters, gastrostomy tubes, haemodialysis or peritoneal dialysis lines – may have been left in situ in the initial post-operative period), and central vascular catheters. Kidney transplant recipients are at higher risk of rickets and fractures. (13)

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

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. 2021 Apr;28(4):444-454.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

EMDocs

NOVEMBER 13, 2023

2021) found that the top 5 reasons for ordering a CTA head/neck were suspected stroke, neurologic problem, dizziness, headache with new/concerning symptoms, and altered mental status. 23 BCVI should be suspected with any high-energy trauma or any fractures of the maxilla or mandible. RadioGraphics 2021, 41 (3), E81-E89.

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Stroke Radiology Radiology Emergency Department 98