RebelEM

NOVEMBER 6, 2024

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (..)

Dislocations 59

Dislocations Fractures Soft Tissue Injuries Outcomes 59

Don't Forget the Bubbles

NOVEMBER 13, 2023

Should we use ultrasound to diagnose distal forearm fractures in children and adolescents? Distal forearm fractures are common in children and adolescents, but the best method for diagnosing them is still debatable. X-ray (radiography) is the standard imaging technique used in emergency departments. N Engl J Med.

Fractures 64

Fractures Ultrasounds Emergency Department Pediatrics 64

Broome Docs

APRIL 6, 2023

2023 Jan 21. Am J Emerg Med. 2023 Feb;64:206.e1-206.e3. 2023 Jan 30. Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK. A prospective cluster-randomized trial to implement the Canadian CT Head Rule in emergency departments.

Sepsis 52

Sepsis Ultrasounds Hospitals Outcomes 52

Don't Forget the Bubbles

SEPTEMBER 30, 2024

In the UK, as in most developed countries, more patients are presenting to Emergency Departments (EDs) with minor illnesses or injuries. Emergency department overcrowding is a complex issue with multiple contributing factors. Learning about international trends sparked our curiosity about our own department.

Emergency Department 89

Emergency Department Research Hospitals Pediatrics 89

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. Laboratory Data CT Orbits/Sella w/ IV Contrast : No acute orbital fracture.

Emergency Department 64

Emergency Department Academics Hospitals Fractures 64

RebelEM

AUGUST 17, 2023

A 24-year-old woman presents to the emergency department with persistent severe pain in her right thigh following a direct blow during a soccer match 2 weeks ago. Rosen’s Emergency Medicine: Concepts and Clinical Practice. Elsevier; 2023:(Ch) 47. Accessed July 7, 2023. Von Fange TJ. Post TW, ed. UpToDate Inc.

EMS 52

EMS Fractures Emergency Department 52

EMDocs

MARCH 30, 2024

Answer : Thoracic and Lumbar Spine Trauma Epidemiology: Approximately half of the vertebral injuries that are seen in the emergency department are thoracic and lumbar injuries. 3,4 Risk factors include engaging in high energy activities, consumption of large amounts of alcohol, osteoporosis, and previous thoracic or lumbar fractures.

EMS 90

EMS Fractures Emergency Department Dislocations 90

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

Don't Forget the Bubbles

JULY 17, 2023

2023 Jun;38(6):1733-1751. 2023 May 16;28(3):172-183. 2023 Jun 6;28(4):205-251. 2023 Jun 6;28(4):252-266. 2023 Jun 1;177(6):559-560. Original clinical studies Distribution and pattern of hand fractures in children and adolescents. 2023 Jun;182(6):2785-2792. 2023 May 16;28(3):184-202. 2023 Jun 1.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

Taming the SRU

MARCH 11, 2024

Acute knee dislocations are rare orthopedic injuries that have high morbidity and need to be recognized quickly by the emergency physician; if unrecognized or inadequately treated, these injuries can lead to vascular and limb compromise (1,2). Knee dislocations make up less than 0.5%

Dislocations 107

Dislocations Emergency Department Fractures Operations 107

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. The Atlas of Emergency Medicine, 5e. Accessed June 24, 2023. Treasure Island (FL): StatPearls Publishing; February 5, 2023. In: StatPearls.

EMS 69

EMS Fractures Operations Ultrasounds 69

EMDocs

SEPTEMBER 9, 2023

The Atlas of Emergency Medicine, 5e. Accessed June 24, 2023. Accessed June 8, 2023. Accessed June 6, 2023. Rosh Review Website Link References Park CW, Juliano ML, Woodhall D. Tendon Lacerations. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. McGraw Hill; 2021. link] Dy CJ, Rosenblatt L, Lee SK. 2013;29(2):261-268.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

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

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

The Skeptics' Guide to EM

APRIL 8, 2023

Date: April 4th, 2023 Reference: Vaughan and Browne. Reconfiguring emergency and acute services: time to pause and reflect. 2023 Apr Guest Skeptics: Dr. Louella Vaugh is an internist practising as a hospitalist physician at an academic centre in London, UK with a special interest in smaller, rural and remote healthcare.

Stroke 55

Stroke Emergency Department Academics COPD 55

Don't Forget the Bubbles

OCTOBER 10, 2024

2023 Mar 30;110(4):432-438. The study excluded complex nail bed injuries, including those with distal phalanx fractures, germinal matrix injury or pulp lacerations, meaning outcomes are only relevant to simple nail bed injuries. 2024 Jul 10:archdischild-2023-326727. doi: 10.1136/archdischild-2023-326727. Arch Dis Child.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

ACEP Now

FEBRUARY 11, 2024

The clavicle is one of the most commonly fractured bones in the human body. Every year, approximately 332,000 people in the United States suffer from a clavicular fracture. The clinician should note the fracture site (either via palpable landmark or ultrasound visualization). Epidemiology of clavicle fractures.

Ultrasounds 52

Ultrasounds Fractures Emergency Department Hospitals 52

ALiEM

APRIL 14, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to related to procedures in the Emergency Department. More specifically, we identified 2 AIR and 4 Honorable Mentions.

EMS 98

EMS Ultrasounds Academics Fractures 98

ACEP Now

OCTOBER 15, 2023

On arrival to the emergency department (ED) she was awake and breathing with stridor. Fracturing the larynx requires considerable force, and the great majority of fractures are from blunt high-velocity trauma. Is there an open neck wound or palpable cartilage fracture?

Fractures 52

Fractures Dislocations Airway Management Operations 52

The Skeptics' Guide to EM

MARCH 25, 2023

Date: March 22, 2023 Reference: Hilsden et al. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. 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

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

Taming the SRU

OCTOBER 20, 2023

Higher sensitivity with the lever sign test for diagnosis of anterior cruciate ligament rupture in the emergency department. October 20, 2023 Guiraud, K. Trauma Surg. 142, 1979–1983 (2022). Clinical Question: Does the lever sign provide improved sensitivity to the diagnosis of acute ACL tear in the ED? Cite As: Glenn, C.

Fractures 95

Fractures Dislocations Emergency Department 95

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

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.” UpToDate , 30 Oct.

EMS 81

EMS Allergic Reactions Poisoning Emergency Department 81

Taming the SRU

NOVEMBER 27, 2023

unported, accessed Oct 2023. international, accessed Oct 2023. international, accessed oct 2023. Patients should be discharged from the Emergency Department with a course of cefalexin plus TMP-SMX, doxycycline, or clindamycin [19]. unported, accessed oct 2023. Anatomy of a fingernail. original image.

Soft Tissue Injuries 94

Soft Tissue Injuries Emergency Department EMS Fractures 94

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. Intraosseous versus central venous catheter utilization and performance during inpatient medical emergencies. Ong MEH, Chan YH, Oh JJ, et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

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. Current bills in progress: US H.R.2663 2663 & S.1176 1176 focuses on violence prevention (introduced for the 3rd time 4/18/23); US H.R.2584 2584 & S.2768

EKG/ECG 93

EKG/ECG Shock Fractures Emergency Department 93

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

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 93

Emergency Department Pediatrics Wellness Documentation/Coding 93

Don't Forget the Bubbles

MAY 8, 2024

2024 Apr 25:archdischild-2023-326533. A silent scream in the pediatric emergency department: child abuse and neglect. 2024 Apr 18:fetalneonatal-2023-326679. 2024 Apr 16:archdischild-2023-326247. 2024 Apr 16:archdischild-2023-326331. 2024 Apr 8:archdischild-2023-326175. JAMA Pediatr. Wong J, et al.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

Don't Forget the Bubbles

JULY 31, 2023

A Diagnostic Accuracy Study to Evaluate Standard Rapid Diagnostic Test (RDT) Alone to Safely Rule Out Imported Malaria in Children Presenting to UK Emergency Departments. 2023 May 31;12(5):290-297. Pediatric Emergency Care March 15, 2023. | 2023 Jun 25. 2023 May;182(5):2205-2214. Epub 2023 Mar 3.

Rapid Diagnostic Testing 98

Rapid Diagnostic Testing Resuscitation Emergency Department Pediatrics 98

Don't Forget the Bubbles

OCTOBER 19, 2023

Dani gave this talk at the Irish Association of Emergency Medicine Annual Scientific Conference in October 2023 Once upon a time, there were two beautiful people, Barbie and Ken. An x-ray confirms a toddler’s fracture. Toddler’s fractures heal quickly, with excellent outcomes. days compared to 1.50 But what will you do?

Head Injuries 81

Head Injuries Fractures Outcomes Hospitals 81

The Skeptics' Guide to EM

AUGUST 5, 2023

Annals of Emergency Medicine 2014. Date: July 10, 2023 Guest Skeptic: Dr. Joe Mullally is a paediatric trainee in the Welsh paediatric training program and interested in Paediatric Emergency Medicine. Annals of Emergency Medicine 2014. Reference: Easter JS et al. Reference: Easter JS et al.

Head Injuries 40

Head Injuries Pediatrics Outcomes Fractures 40

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. Clavicular and humeral fractures are more common in passengers than in drivers. Updated January 20, 2023. Accessed April 3, 2023.

Forensics 52

Forensics Documentation/Coding Head Injuries Fractures 52

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. 2023 Jul 17. Treasure Island (FL): StatPearls Publishing; 2023 Jan– PMID: 28846317. Accessed October 21, 2023.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Taming the SRU

OCTOBER 28, 2024

Potential causes include: -Trauma: Blunt or penetrating thoracic injuries, rib fractures, esophageal rupture (Boerhaave syndrome). When should I get a consultant involved in the emergency department? StatPearls Publishing; Treasure Island (FL): Jul 24, 2023. West J Emerg Med. Updated 2023 May 1]. PubMed] 16.

COPD 78

COPD Pediatrics Emergency Department Ultrasounds 78

Don't Forget the Bubbles

SEPTEMBER 5, 2024

Am J Emerg Med. In the emergency department resuscitation room, weight is usually estimated using an age-based formula until the child is stabilised and can be safely weighed. doi: 10.1136/archdischild-2023-326407. 2023 Aug 23;11:1225087. 2023 Aug;108(8):632-639. doi: 10.1136/archdischild-2023-325343.

Ultrasounds 52

Ultrasounds Research Emergency Department Outcomes 52