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Trauma season is at hand and like all other pediatric emergencydepartments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. Yes, we’re talking about your clavicular , proximal humeral, supracondylar, lateral condylar , scaphoid and metacarpal fractures.
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 (..)
Well keep it short, while you keep that EM brain sharp. A) Factor VIII deficiency B) Hereditary spherocytosis C) Recently reduced closed long bone fracture D) Sickle cell disease Correct answer: D Osteomyelitis is a bacterial infection of the bone typically caused by hematogenous spread of a bloodborne bacteria. C) is seen in 76.3%
Musculoskeletal injuries are a common occurrence, representing a substantial number of EmergencyDepartment visits on an annual basis. 1) Oftentimes, Emergency Physicians are the first provider patients encounter after an injury. This places a significant responsibility on the EM physician to diagnose and treat fractures.
We’ll keep it short, while you keep that EM brain sharp. Answer : Thoracic and Lumbar Spine Trauma Epidemiology: Approximately half of the vertebral injuries that are seen in the emergencydepartment are thoracic and lumbar injuries. A 27-year-old man was brought into the emergencydepartment via EMS after being stabbed.
We’ll keep it short, while you keep that EM brain sharp. He presented to the emergencydepartment because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. A 41-year-old male with no significant past medical history presents with a deep hand laceration.
We’ll keep it short, while you keep that EM brain sharp. 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 emergencydepartment with eye pain. UpToDate , 30 Oct.
Evaluation of unintentional injury and trauma is one of the hallmarks of the EM and PEM physician. Low Risk Inta-Adbominal Trauma: Just Light ‘Em Up? Ann Emerg Med. The post Low Risk Intra-Abdominal Trauma: Rebaked Morsel appeared first on Pediatric EM Morsels. 2013;62:107-116. doi:10.1016/j.annemergmed.2012.11.009.
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 EmergencyDepartment. More specifically, we identified 2 AIR and 4 Honorable Mentions.
A 24-year-old woman presents to the emergencydepartment with persistent severe pain in her right thigh following a direct blow during a soccer match 2 weeks ago. Rezaie, MD (Twitter: @srrezaie ) The post Rosh Review EM Scholar Monthly Question appeared first on REBEL EM - Emergency Medicine Blog. Post TW, ed.
Case A patient arrives via EMS from the bus station complaining of fever, vomiting, and back pain. A trans-esophageal echocardiogram showed a normal ejection fracture, normal right ventricular function, and no vegetations. Their back has worsened significantly over the past 24 hours with radiation down the left leg. 2017 Jun;32:660-6.
Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK. Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK. The X-ray shows a buckle fracture of his right distal radius. Reference: Perry et al.
A Prospective Randomized, Double-Dummy Trial Comparing Intravenous Push Dose of Low Dose Ketamine to Short Infusion of Low Dose Ketamine for Treatment of Moderate to Severe Pain in the EmergencyDepartment. Guest Skeptic: Dr. Salim Rezaie is a faculty physician at Greater San Antonio Emergency Physicians (GSEP) in San Antonio, Texas.
Duchenne Muscular Dystrophy (DMD) is a complex and progressive disease requiring highly specialized care, especially in emergency situations. When patients with DMD present in the EmergencyDepartment (ED), an understanding of the nuanced aspects of their care is essential for optimal management. Orphanet J Rare Dis. Pediatrics.
Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). A 58-year-old male with a history of alcohol abuse presented to the emergencydepartment (ED) as a category 2 trauma for a fall with a reported flail chest. Discussion FIGURE 5: Chest X-ray OF post open reduction and interior fixation of rib fractures.
Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? Annals of EM 2019 Guest Skeptic: Martha Roberts is a critical and emergency care, triple certified nurse practitioner, currently living and working in western Massachusetts. A Randomized Controlled Trial.
A 10-year-old male with no past medical history presents to the EmergencyDepartment (ED) by EMS for evaluation of an injury sustained while playing tackle football. The patient was forcibly hit by another child against a tree.
RESUS SCENARIO Picture this: you just arrived at your shift at the local emergencydepartment. just be careful with pelvic fractures or any femoral arterial punctures/ devices. For more than just the correctness of terminology, the distensibility index should then be calculated.
The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Part 1 here.
World J Emerg Surg 2023 PMID: 36918947 3. Intraosseous vascular access in adults using the EZ-IO in an emergencydepartment. Int J Emerg Med 2009 PMID: 20157465 4. Intraosseous versus central venous catheter utilization and performance during inpatient medical emergencies. Ngo AS, Oh JJ, Chen Y, Yong D, Ong MEH.
He currently serves as Vice-Chair of the Danish Society for Emergency Medicine and Chair of the Young Doctors in Emergency Medicine in Denmark. Date: March 17th, 2021 Guest Skeptic: Dr. Emil Ejersbo Iversen is an emergency medicine resident at the University Hospital of Zealand, Denmark. Reference: Schuster et al.
A Multicenter Program to Implement the Canadian C-Spine Rule by EmergencyDepartment Triage Nurses. Annals of EM Oct 2018 Guest Skeptic: Alison Armstrong is an EmergencyDepartment Nurse, TNCC Course Director, Trauma Program Coordinator and Canadian C-Spine Rule Nurse Champion. Reference: Stiell et al.
Evaluation and Treatment of Acute Back Pain in the EmergencyDepartment. Orthopedic Emergencies 2015 May; 33(2) 311-26. Diagnostic Radiology: Musculoskeletal and Breast Imaging. New Delhi: JP Brothers Medical Ltd; 2012 Della-Guistina, D. PMID: 25892724 Gouliouris T, et al. Spondylodiscitis: update on diagnosis and management.
These patients may be discharged with close outpatient follow-up, and should be instructed to return to the EmergencyDepartment if they develop worsening and/or spreading pain and swelling, as this may be indicative of an infectious process. Antibiotics are not indicated [7, 8].
Case: A 71-year-old man is brought to your emergencydepartment (ED) by emergency medical serviced (EMS) having fallen two steps at home. EMS have already splinted an obvious mid-shaft femoral fracture, but he continues to be tachycardic and hypotensive.
She is interested in social determinants of health in the emergencydepartment and health policy. Dr. Ian Holley is also a PGY-3 resident in Emergency Medicine at Washington University School of Medicine in St. He is interested in ultrasound and international emergency medicine.
This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: EmergencyDepartment Diagnosis and Management. Jeff: And don’t forget to get the crash details from the EMS crew before they depart! Ann Emerg Med. Nachi: Definitely. Prospective; 333 patients) 73.*
EMS appears with a patient who just wiped out big time on the ice. 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. Academic Emergency Medicine, 20(6), 584–591. Maybe he's broken his hip?
A 20-year-old man presents to the emergencydepartment (ED) directly from the scene of a fall from a bicycle, where he lost balance and landed on his outstretched hand. 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.
Hegeman EM, et al. Schwindt EM, et al. Invasive bacterial infection in children with fever and petechial rash in the emergencydepartment: a national prospective observational study. Distribution and pattern of hand fractures in children and adolescents. Pediatr Infect Dis J. 2023 Apr 18. Eur J Pediatr. Pediatrics.
Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant (PA) working primarily in rural Missouri in community hospitals. He also hosts a great #FOAMed blog and podcast called TOTAL EM. first appeared on The Skeptics Guide to Emergency Medicine. He also hosts a great #FOAMed blog and podcast called TOTAL EM.
Traumatic brain injury (TBI) accounts for millions of EmergencyDepartment 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.
There have been many “temporary” rural emergencydepartment closures during the past last year. In Ontario alone there have been approximately 160 emergencydepartments (ED) temporarily closed since the beginning of 2022. It was a stepped-wedge reconfiguration of the entire Danish emergency healthcare system.
The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest.
But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergencydepartment - from low and high voltage injuries to the more extreme and rare lightning related injuries. Jeff: Let’s move on to evaluation in the emergencydepartment. Jeff: You’re right.
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. Emergency Orthopedics 7th Ed.
Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the EmergencyDepartment via EMS altered and potentially critically ill. Trauma CTs showed a "mildly displaced sternal fracture and a small retrosternal hematoma." He was intubated for altered mental status.
Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergencydepartment with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. I sent this to the Queen of Hearts So the ECG is both STEMI negative and has no subtle diagnostic signs of occlusion.
Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine Case: You’re working in a small rural emergencydepartment when a seven-year-old girl comes in by EMS with a head injury. Dad, on the other hand, may need something for anxiety.
Case A 35-year-old male is brought to the emergencydepartment (ED) following a single-motor-vehicle collision in which two people were ejected and pronounced dead at the scene. EMS reports starring and significant damage to the windshield and show you a picture (Figure 1). Imaging and lab studies are ordered. Click to enlarge.)
ems grand rounds: southwest ohio protocol updates WITH dr. weekley Ideally, medications will be administered IV or IO, therefore endotracheal tube drug administration will be de-emphasized. If there is no improvement in 20 minutes, EMS will call medical control regarding further decisions. Remember who you are and who you represent.
Consider starting more goals of care discussions in the emergencydepartment, not just for patients who are actively dying. Consider alternative pathways that can facilitate a quicker disposition such as utilizing CCTAs for chest pain patients. The intensity of the care plan while inpatient tends to follow that started in the ED.
Delayed Identification of Pediatric Abuse-Related Fractures. Teeuw AH, Hoytema van Konijnenburg EM, Sieswerda-Hoogendoorn T, et al. Parents’ Opinions About a Routine Head-to-Toe Examination of Children as a Screening Instrument for Child Abuse and Neglect in Children Visiting the EmergencyDepartment. PEDIATRICS.
However, evaluating and managing patients with acute alcohol intoxication in the emergencydepartment can be challenging. Assess for blood in the nares or signs of basal skull fracture, including battle signs, raccoon eyes, or hemotympanum. Annals of Emergency Medicine. J Emerg Med. 2018 Mar;71(3):279-288.
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