The Skeptics' Guide to EM

MAY 7, 2017

Point-of-care ultrasound for non-angulated distal forearm fractures in children: test performance characteristics and patient-centered outcomes. Acad Emerg Med May 2017. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. The most common type of fractures seen in children are distal forearm fractures.

Fractures 40

Fractures Pediatrics Ultrasounds Academics 40

EB Medicine

NOVEMBER 1, 2021

and get 20% of all orders at [link] Emergency Department Management of Rib Fractures Author: Patrick Maher, MD Episode Outline: Why rib fractures? and get 20% of all orders at [link] Department Management of Rib FracturesAuthor: Patrick Maher, MDEpisode Outline:* Why rib fractures?*

Fractures 52

Fractures Documentation/Coding Operations Emergency Department 52

The Skeptics' Guide to EM

JULY 23, 2022

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.

Fractures 52

Fractures Pediatrics Emergency Department Outcomes 52

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

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. International Consensus Criteria for Pediatric Sepsis and Septic Shock.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

The Skeptics' Guide to EM

JANUARY 26, 2019

IN Fentanyl for Pediatric Pain Management first appeared on The Skeptics Guide to Emergency Medicine. JAMA Pediatrics December 2018 Guest Skeptic: Dr. Samina Ali is a pediatric emergency physician, clinician-scientist, and Professor of Pediatrics & Emergency Medicine at the University of Alberta in Edmonton.

Pediatrics 52

Pediatrics Fractures Research Emergency Department 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 Pediatrics Hospitals 89

PEMBlog

OCTOBER 18, 2024

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 Emergency Department (ED), an understanding of the nuanced aspects of their care is essential for optimal management. Pediatrics. 2018-0333I.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 52

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 value of ultrasound for detecting hand fractures: A meta-analysis. Examination reveals the following: What is the diagnosis? 2012;16(4):338-349.

EMS 94

EMS Fractures Operations Ultrasounds 94

EMDocs

OCTOBER 9, 2023

Yoo, MD (Assistant Professor/Core Faculty, San Antonio, TX) // Reviewed by Brit Long, MD (@long_brit) Case An 18-year-old man with a history of asthma and medication noncompliance presents to the emergency department (ED) with acute onset shortness of breath. Pediatr Nephrol. Which one do you select? 2015;116(6):960-975.

Basic Life Support 107

Basic Life Support CPR Fractures Emergency Department 107

Northwestern EM Blog

DECEMBER 20, 2021

Written by: Tommy Ng, MD (NUEM ‘24) Edited by: Patricia Bigach, MD (NUEM ‘22) Expert review by : Terese Whipple, MD '20 So your kid won’t walk One of the most common complaints in a pediatric Emergency Department is a child refusing or inability to ambulate. Curr Opin Pediatr. Hip Pain in Pediatrics. 2021, Dec 20).

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Don't Forget the Bubbles

MAY 17, 2023

’, ‘ Who can best score postoperative pain: parents or the children? ’, ‘ Is functional constipation associated with hypohydration? ’, ‘ Who is best at assessing foreign body aspiration on chest X-ray: pediatric pulmonologists, pediatric residents, or radiologists? ’ Eur J Pediatr. Eur J Pediatr. Eur J Pediatr.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Don't Forget the Bubbles

MAY 8, 2024

An interesting study (JAMA Pediatrics) shows the benefits of newborn screening for spinal muscular atrophy (SMA), as initiating disease-modifying therapy earlier improves clinical outcomes. Pediatr Nephrol. Eur J Pediatr. Long COVID in pediatrics-epidemiology, diagnosis, and management. Eur J Pediatr. JAMA Pediatr.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

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 95

Emergency Department Pediatrics Wellness Fractures 95

EM Curious

JULY 24, 2015

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. Ultrasound-Guided Three-In-One Nerve Block for Femur Fractures. doi:10.1111/acem.12154

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

The Skeptics' Guide to EM

NOVEMBER 9, 2019

Case: A 6-year-old boy comes into your emergency department at around midnight with his parents complaining of abdominal pain. This has included performing lumbar punctures, diagnosing acute abdominal aneurysms, acute heart failure, pediatric fractures, retinal detachments and endotracheal tube placement.

Ultrasounds 52

Ultrasounds Fractures Pediatrics Radiology 52

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

Pediatric Education

MARCH 17, 2024

If there is any concern for significant trauma including potential fracture, the elbow should be stablized and radiographs obtained, before attempting RHS reduction maneuvers. If there is a fracture or it is unclear if there is a fracture, then the elbow should be stabilized and orthopaedics consulted. J Emerg Med.

Dislocations 40

Dislocations Fractures Pediatrics Urgent Care 40

Taming the SRU

SEPTEMBER 15, 2023

ETT onto a fiberoptic scope.

CPR 91

CPR Burns Airway Management Wellness 91

RebelEM

JANUARY 30, 2023

PSA, also referred to as intravenous sedation in this paper, requires considerable resources, including 1:1 nursing observation, and burdens the emergency department (ED). Canadian Journal of Emergency medicine. Paper: Sithamparapillai A, Grewal K, Thompson C, Walsh C, McLeod S. vs. 91.4%; RR 0.93; 95% CI 0.86–1.01,

Dislocations 58

Dislocations Emergency Department Outcomes Research 58

Don't Forget the Bubbles

OCTOBER 2, 2024

A previously well 6-year-old boy is brought into the emergency department at a major trauma centre via HEMS following a road traffic accident, in which he was hit by a car while crossing the road. He is diagnosed with a traumatic brain injury and a fracture to his right tibia and fibula. Pediatric Critical Care Medicine.

Administration 49

Administration Pediatrics Outcomes Research 49

PEMBlog

SEPTEMBER 13, 2023

battle sign bruises around the mastoid, raccoon eyes, or other bruising and lacerations) or reported by history – but could be identified (later) with a bleed or fracture on a head CT scan if your index of suspicion is high or the seizure is going well beyond the expected duration and not responding well to antiepileptics. Pediatrics.

Seizures 52

Seizures Pediatrics Point-of-Care Testing Wellness 52

Broome Docs

APRIL 6, 2023

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. Epinephrine metered-dose inhaler for pediatric croup. Acad Emerg Med. doi: 10.1503/cmaj.091974.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Taming the SRU

AUGUST 30, 2023

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. Evaluation of fever in the emergency department. ng/mL (strongly recommended against antibiotics), 0.1-0.25

Infectious Diseases 90

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 90

Don't Forget the Bubbles

SEPTEMBER 5, 2024

Comparing the performance of pediatric weight estimation methods. 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. Front Pediatr. Shieh A, Rogers AJ, Chen CM, Ramgopal S. 2024 Aug;82:26-32.

Ultrasounds 52

Ultrasounds Research Emergency Department Outcomes 52

Pediatric EM Morsels

MAY 24, 2024

One of the most difficult and most satisfying parts of pediatric emergency medicine is using one’s history, exam and clinical tools to make an informed decision and spare children from unnecessary pain , uncomfortable exams, painful procedures and medical imaging. Low Risk Inta-Adbominal Trauma: Pediatric Trauma is Dangerous!

Pediatrics 164

Pediatrics Blood Transfusions EMS Fractures 164

Don't Forget the Bubbles

DECEMBER 2, 2024

A Quality Improvement Initiative to Minimize Unnecessary Chest X-Ray Utilization in Pediatric Asthma Exacerbations. Pediatr Qual Saf. AAE is a very common cause of hospital visits in pediatric EDs. Quality Indicators of Pediatric Asthma Care in the Emergency Department; a Systematic Review and Meta-Analysis.

Documentation/Coding 98

Documentation/Coding Pediatrics Emergency Department Fractures 98

Don't Forget the Bubbles

NOVEMBER 29, 2023

You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. Ben has a possible skull fracture and has been intubated, but his oxygen requirement is minimal. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

The Skeptics' Guide to EM

JULY 17, 2018

Validation of the Pediatric NEXUS II Head Computed Tomography Decision Instrument for Selective Imaging of Pediatric Patients with Blunt Head Trauma. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. [display_podcast] Date: July 16th, 2018 Reference: Gupta M et al.

Pediatrics 52

Pediatrics Head Injuries Academics Emergency Department 52

EB Medicine

NOVEMBER 1, 2018

But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. Jeff: Let’s move on to evaluation in the emergency department. Jeff: You’re right.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EM Guide Wire

MAY 19, 2019

PEDIATRICS. Pediatrics in Review. PEDIATRICS. Pediatric Clinics of North America. Delayed Identification of Pediatric Abuse-Related Fractures. PEDIATRICS. PEDIATRICS. Detection of child abuse and neglect in the emergency room. European Journal of Pediatrics. Christian CW.

Pediatrics 40

Pediatrics Soft Tissue Injuries Fractures Emergency Nursing 40

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. J Pediatric Infect Dis Soc. A Quest for Better Strategy in Pediatric Intraosseous Placement Using Radiographic Measurements in Patients Younger Than 2 Years.

Rapid Diagnostic Testing 98

Rapid Diagnostic Testing Resuscitation Emergency Department Pediatrics 98

PEMBlog

JUNE 5, 2024

It was inspired by a hot-off-the-presses publication from the Pediatric Emergency Care Applied Research Network (PECARN) focused on clinical decision rules for cervical spine imaging in children. Pediatrics. Evaluation of pediatric cervical spine injuries. Am J Emerg Med. Pediatrics. Ann Emerg Med.

Fractures 52

Fractures Pediatrics Radiology Radiology 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 98

EMS Allergic Reactions Poisoning Emergency Department 98

EMDocs

JULY 11, 2023

Pediatric patients: Post circumcision bleed, head bleeds, bruises. PECARN Pediatric Head Injury/Trauma Algorithm, Canadian CT Head Injury Rule, Ottawa Knee and Ankle Rules) do not apply to those with hemophilia and should not guide management. Fractures and dislocations are indications for full dose factor replacement.

Head Injuries 75

Head Injuries Pediatrics Dislocations CDC 75

Taming the SRU

FEBRUARY 23, 2024

Consider starting more goals of care discussions in the emergency department, not just for patients who are actively dying. There are several guidelines outlining when to obtain a CT head prior to LP (but all agree that if suspecting acute bacterial meningitis you should empirically treat if delaying LP for CT).

Pediatrics 75

Pediatrics Ultrasounds Fractures Wellness 75

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Crash course in pediatric anatomy and physiology in trauma When you think of trauma in children, think of Charlie Brown. Depending on the height of the child and the height of the car, the initial impact will cause a femur fracture, a pelvic fracture, or direct abdominal trauma. In pediatric trauma, we need to be proactive.

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Resuscitation Pediatrics Fractures Emergency Department 40