Pediatric EM Morsels

SEPTEMBER 22, 2023

Most commonly caused by fracture or dislocation of vertebrae. Updated 2022 Feb 10]. Updated 2022 Mar 3]. Pathophysiology Primary injury happens at the time of the traumatic event or shortly after in the high cervical to mid-thoracic spine. This leads to descending sympathetic tracts being disrupted. 5 th Edition. 5 th Edition.

Shock 304

Shock Pediatrics Dislocations Hyperthermia / Hypothermia 304

Mount Sinai EM

JANUARY 11, 2023

Updated 2022 Apr 28]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. In: Sherman SC. Simon’s Emergency Orthopedics, 8e. Ankle (lateral view). Reference article, Radiopaedia.org (Accessed on 04 Jan 2023) [link] Patel P, Russell TG. Ankle Radiographic Evaluation. In: StatPearls [Internet]. Ankle & Hindfoot.

Radiology 130

Radiology Radiology Fractures Dislocations 130

Mount Sinai EM

DECEMBER 27, 2022

Illustration by Yvonne Chow The Lisfranc Injury The lisfranc injury is any disruption of the joint and is a spectrum including ligamentous injury, dislocations and fractures. High energy mechanisms, such as MVCs or falls, are more likely to cause fracture-dislocations. Normal Lisfranc joint and ligament. Lisfranc injury.

Dislocations 130

Dislocations Fractures Operations Radiology 130

Board Bombs

NOVEMBER 27, 2022

This epic podcast covers the major facial fractures, when to call a surgeon, and who needs to be seen in emergently in the ED vs outpatient. Oh, and please dont call for plastic surgery consult on nasal bridge fractures. November 18th, 2022. Oh, and please dont call for plastic surgery consult on nasal bridge fractures.

Fractures 52

Fractures 52

Board Bombs

NOVEMBER 27, 2022

This epic podcast covers the major facial fractures, when to call a surgeon, and who needs to be seen in emergently in the ED vs outpatient. Oh, and please don’t call for plastic surgery consult on nasal bridge fractures. November 18th, 2022. Oh, and please don’t call for plastic surgery consult on nasal bridge fractures.

Fractures 52

Fractures 52

The Skeptics' Guide to EM

JULY 23, 2022

Date: July 22nd, 2022 Reference: Perry et al. Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK. Date: July 22nd, 2022 Reference: Perry et al. The X-ray shows a buckle fracture of his right distal radius. He has bony tenderness at the distal radius.

Fractures 52

Fractures Pediatrics Emergency Department Outcomes 52

Northwestern EM Blog

MARCH 1, 2025

This maneuver improves oxygenation and gas exchange via three main mechanisms (Malhotra, 2022): 1. It is the distending force of the lungs, opposing the innate inward elastic recoil of the lung parenchyma (Neupane and Jamil, 2022). What are the physiologic effects of proning?

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

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 110

EKG/ECG Fractures Burns Wellness 110

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 ). 2022 Apr;54:328.e3-328.e4. Some of those causes are benign (ex, Osgood Schlatter’s Disease ) while others are scary (ex, osteosarcoma ). Am J Emerg Med.

Dislocations 143

Dislocations Fractures Pediatrics EMS 143

The Skeptics' Guide to EM

DECEMBER 10, 2022

Date: November 30th, 2022 Reference: Johnson et al. One-year outcome of surgery compared with immobilization in a cast for adults with an undisplaced or minimally displaced scaphoid fracture: A meta-analysis of randomized controlled trials. Date: November 30th, 2022 Reference: Johnson et al.

Operations 52

Operations Fractures Military Emergency Department 52

Mind The Bleep

AUGUST 18, 2024

Patients with orbital fractures will present with swelling and periorbital bruising. Examination of possible orbital floor fracture: Presence of proptosis/exophthalmos, enophthalmos or hypoglobus Visual acuity in both eyes Check eye movements Presence of diplopia and in which gaze? This normally resolves once the swelling improves.

Fractures 91

Fractures Soft Tissue Injuries Burns Emergency Department 91

ALiEM

APRIL 14, 2023

Highlighted Quality Posts: Procedures Site Article Author Date Label Rebel EM Intra Articular Lidocaine vs Sedation in Shoulder Reductions Nordia Matthews, MD 30 Jan 2023 AIR EM Docs Video Laryngoscopy in the ED Cameron Jones, MD 8 Aug 2022 AIR First 10 EM Lacerations: Does closure technique matter?

EMS 98

EMS Ultrasounds Fractures Academics 98

Pediatric EM Morsels

JUNE 16, 2023

2022) Morel-lavallee lesions – diagnosis and practical management of these troublesome injuries! Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Arch Gen Med. and Taylor, B.

Soft Tissue Injuries 154

Soft Tissue Injuries Dehydration Fractures Operations 154

Taming the SRU

OCTOBER 27, 2023

39, 655–661 (2022). As ED physicians we often must determine whether the shoulder is fractured, dislocated, or both. RESULTS A total of 290 dislocations (control group, n=132; experimental group, n=158) and 332 proximal humerus fractures (control group, n=154; experimental group, n=178). and a specificity of 99.1%.

Dislocations 95

Dislocations Fractures Ultrasounds Emergency Department 95

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 105

EMS Fractures Emergency Department Dislocations 105

EMDocs

DECEMBER 19, 2023

Accessed August 25, 2022. Accessed August 25, 2022. McGraw Hill; 2022. Accessed August 25, 2022. Accessed August 25, 2022. Accessed August 25, 2022. Accessed August 25, 2022. Accessed August 25, 2022. Accessed August 25, 2022. Accessed August 25, 2022. McGraw Hill; 2020.

Poisoning 105

Poisoning Seizures Anaphylaxis Burns 105

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. Next of interest is a secondary analysis of the MATIC study – the MA ssive T ransfusion I n C hildren study, published in 2022. 2022 May;55:103-110.

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

EMDocs

AUGUST 12, 2023

The value of ultrasound for detecting hand fractures: A meta-analysis. Open Fracture. Emergency Medicine Residents’ Association; 2022:10-11. The athlete’s hand: ligament and tendon injury. Semin Musculoskelet Radiol. 2012;16(4):338-349. doi:10.1055/s-0032-1327007 Zhao W, Wang G, Chen B, et al. Medicine (Baltimore).

EMS 96

EMS Fractures Operations Ultrasounds 96

RebelEM

MAY 25, 2023

Pelvic Fracture A score ≥2 present, consider MTP Clinical Take Home Point: Use of balanced transfusion (including PRBCs and clotting factors) helps avoid dilutional coagulopathy WHOLE BLOOD VS COMPONENT THERAPY Kronstedt S et al. Lancet Haematol 2022. Cureus 2022. J Trauma Acute Care Surg 2022.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

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. and cardiovascular disease (OR 1.2-2.56).

Basic Life Support 109

Basic Life Support CPR Fractures Emergency Department 109

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Rib fractures account for over 15% of all trauma attendances in the Emergency Department. Among patients with multiple rib fractures, the mortality rate can reach a staggering 33%, and this risk doubles for individuals above the age of 65. Abstract 2268 Table 1 Rib-fracture Data Set March 2022 – June 2023

Fractures 40

Fractures Anaphylaxis Emergency Department Ultrasounds 40

Taming the SRU

OCTOBER 20, 2023

142, 1979–1983 (2022). Guiraud, K. Higher sensitivity with the lever sign test for diagnosis of anterior cruciate ligament rupture in the emergency department. Trauma Surg. Clinical Question: Does the lever sign provide improved sensitivity to the diagnosis of acute ACL tear in the ED?

Fractures 95

Fractures Dislocations Emergency Department 95

Don't Forget the Bubbles

MARCH 4, 2024

doi: 10.1136/emermed-2022-212931. Reviewed by: Kieran McDonnell Article 4: Diagnosing Paediatric Distal Forearm Fractures with Ultrasound Snelling PJ, Jones P, Bade D, Bindra R, Davison M, Gillespie A, et al. This was an RCT comparing the accuracy of point-of-care ultrasound to x-ray in diagnosing non-deformed distal forearm fractures.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Trauma CTs showed a "mildly displaced sternal fracture and a small retrosternal hematoma." Retrieved July 2, 2022, from [link] Moyé, D. Retrieved July 2, 2022, from [link] Sybrandy, K. I've copied KEY points from My Comment in the August 6, 2022 post in Dr. Smith's ECG Blog — regarding the answer to this question.

EKG/ECG 115

EKG/ECG Wellness Fractures Emergency Department 115

Don't Forget the Bubbles

OCTOBER 19, 2023

An x-ray confirms a toddler’s fracture. You have four options: Above knee cast Below knee cast Boot Nothing Our approach to managing toddler’s fractures mostly comes from retrospective case studies and only two small prospective case series. Toddler’s fractures heal quickly, with excellent outcomes. But what will you do?

Head Injuries 81

Head Injuries Fractures Outcomes Hospitals 81

ALiEM

OCTOBER 30, 2024

A trans-esophageal echocardiogram showed a normal ejection fracture, normal right ventricular function, and no vegetations. Drug Checking Quarterly Report (Q3 2022). 2022; 06/26/2023. 2022 May;14(5). Clinical impact: The patient’s DVT ultrasounds were negative. Xylazine (veterinary sedative) use in Puerto Rico.

Emergency Department 64

Emergency Department Operations Psychiatric EMS 64

Taming the SRU

JANUARY 10, 2024

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. Additionally, ED boarding is a now a larger factor than in 2018.

EKG/ECG 93

EKG/ECG Shock Fractures Dislocations 93

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

The Skeptics' Guide to EM

DECEMBER 17, 2022

Date: December 16th, 2022 Reference: Hohle et al. AEM December 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Date: December 16th, 2022 Reference: Hohle et al. Massive Blood Transfusion Following Older Adult Trauma: the Effect of Blood Ratios on Mortality.

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 52

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]. Treasure Island (FL): StatPearls Publishing; June 29, 2022. [5] Paronychia Drainage.

Soft Tissue Injuries 95

Soft Tissue Injuries Emergency Department EMS Fractures 95

RebelEM

APRIL 29, 2024

2022 PMID: 35206981 2. Healthcare 2022 PMID: 35206981 Post Peer Reviewed By: Frank Lodeserto, MD & Salim R. Additional sites such as the sternal, iliac crest, distal femur, and distal tibia have also been utilized, and the use of these alternative sites should be considered based on the clinical presentation. Healthcare.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

JournalFeed

DECEMBER 10, 2022

The JournalFeed podcast for the week of Dec 5-9, 2022. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Delirium = CT Spoon Feed Among patients ≥65 years who presented to the ED with delirium, confusion, or altered mental status, 15.6%

Hospitals 40

Hospitals Fractures 40

ACEP Now

MAY 4, 2023

Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). The chest X-ray showed multiple displaced right rib fractures and chest wall subcutaneous emphysema without definitive evidence of a pneumothorax, as well as right lower lobe atelectasis versus contusion (Figure 1). 2022; 22(11):432-439. 2022; 276:221-234.

EMS 52

EMS Fractures Operations Radiology 52

Don't Forget the Bubbles

MAY 17, 2023

2023 Apr 20:fetalneonatal-2022-324835. 2023 Apr 4:archdischild-2022-325281. Distribution and pattern of hand fractures in children and adolescents. Increased fracture risk among children diagnosed with attention- deficit/hyperactivity disorder: a large matched cohort study. Kuypers KLAM, et al. Hegeman EM, et al.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

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. Clin Cardiol 2022 4. But does this matter?

EKG/ECG 121

EKG/ECG Documentation/Coding Fractures Emergency Department 121

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. Two-thirds of the responses agreed with me.

Leadership 127

Leadership Fractures Wellness 127

Northwestern EM Blog

FEBRUARY 7, 2022

In this situation, it is better to rule out a fracture first than to attempt a reduction without imaging. Attempted reduction could worsen or lead to displacement of a supracondylar humerus fracture if that is present. 2022, Feb 7). Nursemaid’s Elbow. Expert Commentary by Stelter, J].

Fractures 52

Fractures Pediatrics 52