RebelEM

JANUARY 30, 2023

Background: Many clinicians have transitioned from procedural sedation and analgesia (PSA) in favor of intra-articular lidocaine (IAL) to manage anterior shoulder dislocation. PMID: 36181665 Clinical Question: In patients with acute anterior shoulder dislocations, how does IAL compare to PSA for closed reduction?

Dislocations 59

Dislocations Emergency Department Outcomes Research 59

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]. As an EM physician, it is important to have an understanding of the spectrum of ankle injuries and how these are appropriately evaluated. Range all joints.

Fractures 77

Fractures Dislocations Operations Radiology 77

EMergucate

AUGUST 2, 2024

Monteggia fracture-dislocation. There is fracture involving proximal third of ulna & disruption of radio capitellar line indicating dislocation of the … Continue reading →

Dislocations 52

Dislocations Fractures EMS 52

Taming the SRU

MAY 23, 2023

As an EM physician, it is important to have an understanding of the spectrum of foot injuries and how these are appropriately evaluated. fractures of the talar body, talar neck, and calcaneus require high-impact trauma). Gross deformities often suggest fracture or dislocation. Range all joints.

Fractures 57

Fractures Dislocations Operations EMS 57

ACEP Now

MARCH 15, 2024

3 Tenderness over the distal radial metaphysis after wrist injury is strongly suggestive of a distal radius fracture despite normal plain radiographs and fluoroscopic images. Children and older adults have weaker long bones than young adults and are more likely to sustain a distal radius fracture after a FOOSH than a carpal bone injury.

Fractures 52

Fractures Dislocations EMS Emergency Department 52

EMergucate

JANUARY 29, 2024

The wrist x-rays show multiple fractures but the main injury is trans scaphoid perilunate dislocation. There are also fractures involving … Continue reading →

Dislocations 52

Dislocations Fractures EMS 52

EM Curious

JULY 11, 2015

Case by Sean Dyer PGY-3 EM Resident; Peer Reviewed by Dr. Christopher Hogrefe, Assistant Professor in Emergency Medicine at Northwestern University Feinberg School of Medicine The Case A 32 y/o male presents with wrist pain after being involved in a motor vehicle collision this afternoon. References: Sherman, S.

Dislocations 52

Dislocations Emergency Department Fractures Outcomes 52

EMergucate

JANUARY 16, 2021

The elbow x-rays show a Monteggia fracture dislocation. There is a fracture of the proximal ulnar shaft with a dislocation … Continue reading →

Dislocations 40

Dislocations Fractures EMS 40

EMergucate

MARCH 22, 2020

The elbow x-ray shows a fracture involving the olecranon process. There is also radial head dislocation (radiocapitellar line is broken). … Continue reading →

Dislocations 40

Dislocations Fractures EMS 40

EMergucate

NOVEMBER 28, 2020

The wrist x-rays show a trans-scaphoid peri-lunate dislocation. There are fractures involving the radial & ulnar styloid, mid-scaphoid, and triquetrum … Continue reading →

Dislocations 40

Dislocations Fractures EMS 40

EMergucate

SEPTEMBER 16, 2012

Monteggia fracture dislocation was first described in 1814 by Giovanni Battista Monteggia, 81 years before Roentgen described use of Xrays for medical … Continue reading →

Dislocations 40

Dislocations Fractures EMS 40

Emergency Medicine Cases

JANUARY 24, 2017

Arun Sayal and Hossein Mehdian answer questions such as: When should we suspect a spontaneously reduced knee dislocation? Do all patients suspected of a spontaneous knee dislocation require a CT angiogram to rule out vascular injury? Which patients with a low energy mechanism are at risk for knee dislocation and vascular complications?

Soft Tissue Injuries 52

Soft Tissue Injuries Dislocations Ultrasounds Fractures 52

EM Curious

JULY 24, 2015

EMS appears with a patient who just wiped out big time on the ice. Maybe it's dislocated? It's a bit of a departure from what we've described above--he mainly goes right at a shaft fracture--but it's the same general idea: As always, these posts are for EDUCATIONAL PURPOSES ONLY. Maybe he's broken his hip? doi:10.1111/acem.12154

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

Taming the SRU

FEBRUARY 23, 2024

Location of the block will determine the morphology of the QRS (as a higher block may have a narrow QRS with a rate of 40-60bpm) Evaluation in the ED: basic labs including BMP and troponin, EKG, bedside echo, CXR Management: Atropine: push-dose 0.5-1mg,

Pediatrics 74

Pediatrics Ultrasounds Fractures Wellness 74

Emergency Medicine Cases

JANUARY 2, 2024

Triquetrum chip fractures, scapholunate injuries, hook of the hamate fractures, and of course, scaphoid fractures can be easily missed with serious consequences for our patients.

Fractures 52

Fractures Wellness Dislocations EMS 52

Emergency Medicine Cases

FEBRUARY 26, 2019

In this main episode podcast we discuss the pitfalls in the diagnosis and management of elbow injuries and answer questions such as: What is an easy way to remember the surgical indications for radial head fractures? Why is it so important to assess for the extensor mechanism on physical exam for patients with olecranon fractures?

Soft Tissue Injuries 52

Soft Tissue Injuries Fractures Operations Dislocations 52

EM Curious

JULY 10, 2015

Furthermore, there is good evidence in the literature to support the use of ultrasound to accurately identify multiple shoulder pathologies including shoulder dislocation, rotator cuff tear, clavicle fracture and AC joint separation. The infraspinatus tendon will run just superior to these structures.

Leadership 52

Leadership Ultrasounds Dislocations Fractures 52

EMergucate

JULY 17, 2022

The forearm AP x-ray shows fracture of upper third of ulna with an impacted radial neck fracture. The radio-capitellar line … Continue reading →

Fractures 52

Fractures Dislocations EMS 52

EMergucate

MAY 22, 2020

The frontal wrist x-ray shows a scaphoid fracture. There is crowding of the carpal bones as opposed to what should … Continue reading →

Fractures 40

Fractures Dislocations EMS 40

EMergucate

AUGUST 16, 2020

The frontal left wrist x-ray indicates an ulnar styloid fracture. The carpal bones appear crowded with the loss of the … Continue reading →

Fractures 40

Fractures Dislocations EMS 40

EMergucate

OCTOBER 5, 2019

There is an undisplaced olecranon fracture. The elbow x-ray shows haemathrosis as evidenced by elevated anterior & posterior fat pads. … Continue reading →

Fractures 40

Fractures Dislocations EMS 40

EMDocs

MARCH 30, 2024

We’ll keep it short, while you keep that EM brain sharp. 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.

EMS 89

EMS Fractures Emergency Department Dislocations 89

EMergucate

JULY 1, 2022

The frontal wrist x-ray shows loss of normal 1-2 mm distance between the the carpal bones and there is crowding … Continue reading →

Dislocations 52

Dislocations Fractures EMS 52

EMDocs

NOVEMBER 6, 2024

Temporomandibular dislocation: a complication of tetanus. tetani infection is also indicated. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(4):437-441. doi:10.1016/j.tripleo.2005.04.013 2005.04.013 Alfery DD, Rauscher LA. Tetanus: a review. Crit Care Med. 1979;7(4):176-181. J Trop Med Hyg. 1993;96(1):60-61.

Poisoning 76

Poisoning Airway Management Dislocations Forensics 76

EMDocs

JUNE 3, 2023

How should pelvic fractures be identified in unstable trauma patients? What is the EM physician’s role in the stabilization of unstable pelvic injuries? Pelvic fractures can involve disruptions in any of the bony or ligamentous structures of the pelvic ring. While single-bone fractures can occur, they are far less common.

Fractures 54

Fractures Resuscitation Operations EMS 54

RebelEM

MAY 22, 2023

For instance, while pain resulting from extremity fractures and dislocations can often be relieved after reduction and splinting, abdominal pain poses a more elusive and complex scenario involving multiple contributing factors. Beyond the patient’s age and location of pain, we know very little of the cause or prognosis in this paper.

Administration 78

Administration Emergency Department Dislocations Hospitals 78

EMDocs

NOVEMBER 16, 2024

We’ll keep it short, while you keep that EM brain sharp. Answer : Posterior dislocation of a periprosthetic hip Epidemiology: Total Hip Arthroplasty (THA) is the 4 th most common surgical procedures in the United States (2.3% 4 Dislocation is the most common complication after THA occurring at a rate of 0.2-10% 10% of patients.

EMS 75

EMS Dislocations Fractures Operations 75

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. Per EMS, the patient was found at the bottom of a high voltage line with diffuse burns and amputation of his left forearm.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

EMDocs

SEPTEMBER 21, 2024

We’ll keep it short, while you keep that EM brain sharp. A 17-year-old right hand dominant male with no past medical history comes in complaining that he broke his right finger after being tackled at football practice. He has full ROM at the wrist, elbow, and shoulder. What is the diagnosis?

Dislocations 74

Dislocations EMS Fractures Operations 74

EB Medicine

NOVEMBER 1, 2018

Jeff: With your initial stabilization underway, you can begin to gather a more thorough history either from bystanders or EMS if they are still present. Cerebral salt wasting syndrome, peripheral nerve lesions, spinal cord fracture, and cerebral hemorrhages have all been described.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

RebelEM

DECEMBER 18, 2024

Temporomandibular (TMJ) Joint Dislocation Definition: Displacement of the mandibular condyle from the temporomandibular fossa. Epidemiology: Anterior dislocations are most common Mechanism Atraumatic (most common) from extreme mouth opening (yawning, eating, dental procedure, etc).

Dislocations 52

Dislocations Fractures Operations EMS 52