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

Taming the SRU

MAY 23, 2023

fractures of the talar body, talar neck, and calcaneus require high-impact trauma). Stress fractures are caused by repetitive microtrauma and stress on the bone, and therefore present with more subacute or chronic symptoms. Gross deformities often suggest fracture or dislocation. RICE), and symptomatic management (e.g.,

Fractures 57

Fractures Dislocations Operations EMS 57

EMDocs

SEPTEMBER 9, 2023

Treasure Island (FL): StatPearls Publishing; November 15, 2022. Dec 21, 2022. The value of ultrasound for detecting hand fractures: A meta-analysis. In: StatPearls. Amirtharajah M, Lattanza L. Open extensor tendon injuries. J Hand Surg Am. 2015;40(2):391-398. doi:10.1016/j.jhsa.2014.06.136 2014.06.136 Jones, O. Teach Me Anatomy.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

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 70

EMS Fractures Operations Ultrasounds 70

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. 2022 PMID: 35206981 2.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

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

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). Click to enlarge.) Click to enlarge.) Click to enlarge.)

EMS 52

EMS Fractures Operations Radiology 52

Don't Forget the Bubbles

MAY 17, 2023

Post-operative pain in children: Comparison of pain scores between parents and children. 2023 Apr 20:fetalneonatal-2022-324835. 2023 Apr 4:archdischild-2022-325281. Distribution and pattern of hand fractures in children and adolescents. J Pediatr Gastroenterol Nutr. 2023 Apr 24. Cetinkaya PG, et al. Eur J Pediatr.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Medical Law

NOVEMBER 12, 2021

Lack of properly trained ride operators can lead to negligent operation that causes injuries to guests. Common theme park injuries include: Fractured bones. How Can Theme Park Operators Be Held Accountable for an Understaffed Theme Park? Lack of trained supervision for rides can lead to patrons being hurt.

Soft Tissue Injuries 52

Soft Tissue Injuries Operations Fractures 52

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. 1 The Rise of the Miami BBL An entire industry has emerged around gluteal AFTs in Miami.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

The Skeptics' Guide to EM

MARCH 25, 2023

Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

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. 2022 Apr 26. The remainder of the physical examination is unremarkable. Olivia Gobble AND THE ANNALS OF B POD EDITORS References 1.Navarrete

Emergency Department 92

Emergency Department Fractures Hospitals Operations 92

RebelEM

MARCH 9, 2023

Keyes 2022) Auditory and Visual Hallucinations (AH/VH) : The differential diagnosis for hallucinations is broad and includes medical pathology, psychiatry pathology, and transient causes such as acute drug intoxication. Assess for blood in the nares or signs of basal skull fracture, including battle signs, raccoon eyes, or hemotympanum.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

ACEP Now

MARCH 14, 2024

In our case, the patient had a CT of the head, cervical spine, and chest, abdomen, and pelvis with intravenous contrast demonstrated a C2, C7 compression fracture with significant bowel edema (Figure 4), and was taken to the operating room for left arm disarticulation, left below knee amputation and right above knee amputation.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Northwestern EM Blog

APRIL 25, 2022

X - ray : Many times, next step will be to get an X-ray to look for associated fractures. Definitive treatment is joint wash out in the Operating Room. It provides additional information about any associated fractures. 2022, Apr 25). If the diagnosis is still in question, I prefer CT in most scenarios. CT is painless.

Soft Tissue Injuries 52

Soft Tissue Injuries Fractures Sepsis Documentation/Coding 52

Cook County EM Blog

MARCH 20, 2023

X-rays showed radiopaque foreign bodies confined to the distal thumb without fracture. There were no signs of infection, compartment syndrome, tissue necrosis, or limb ischemia. Orthopedics was consulted and recommended outpatient follow up in several days. PMID: 18923762; PMCID: PMC2532970. Joseph T, Rolando GG. ISSN 0736-4679. 2022.05.017.

Documentation/Coding 52

Documentation/Coding Fractures Operations Research 52

Taming the SRU

AUGUST 30, 2023

A larger 2022 meta-analysis in the journal of Clinical Microbiology and Infection examined different test modalities for diagnosing pneumonia in the setting of clinical suspicion for acute community-acquired lower RTI in outpatient clinics, LTACs, and the emergency department. 2022 Jul 11;11(14):2163. 2022 Jan;28(1):13-22.

Infectious Diseases 87

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

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. Amer J Rad. Zhou and Xia.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

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 76

EMS Dislocations Fractures Operations 76

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

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. Drug Checking Quarterly Report (Q3 2022). 2022; 06/26/2023. 2022 May;14(5). 2011 Dec;6:1-4.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

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 30 , 14 (2022). Nutbeam, T.

Fractures 52

Fractures Operations Outcomes Academics 52

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

JUNE 21, 2023

Labs do not play a significant role Imaging X-ray : Start with plain films to look for fracture near laceration, intra-articular free air, radiopaque foreign body. Common operator errors Failing to enter joint capsule before injecting STS. 2022 Jan 21;54:41-45. While suggestive of TA, not sensitive or specific.

Soft Tissue Injuries 69

Soft Tissue Injuries Fractures Dislocations Radiology 69

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. Most cases abate by one year.

Emergency Department 99

Emergency Department Fractures Burns EMS 99

EMDocs

NOVEMBER 13, 2023

23 Blunt carotid injury is more likely in patients with at least one of the following: Glasgow Coma Scale (GCS) ≤ 6, fracture of petrous bone, presence of diffuse axonal brain injury, and LeFort II/III fractures. 23 BCVI should be suspected with any high-energy trauma or any fractures of the maxilla or mandible. 21.26543. (3)

Stroke 87

Stroke Radiology Radiology Emergency Department 87