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Ultrasonography or radiography for suspected pediatric distal forearm fractures. New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Reference: Snelling et al. Reference: Snelling et al.
Which clinical features best predict occult scaphoid fractures? Emerg Med J. He will soon be transitioning out of the US military after […] The post SGEM#420: I get knocked down, but I get up again – do I have a scaphoid fracture? first appeared on The Skeptics Guide to Emergency Medicine. Emerg Med J.
Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergencydepartment: A randomized controlled trial. His imaging shows mildly displaced rib fractures of ribs four through seven.
Identification and Management of Pelvic Fractures in Prehospital and EmergencyDepartment Settings – Journal of Surgical Research — Read on www.journalofsurgicalresearch.com/article/S0022-4804(24)00261-0/fulltext
Similarly, the Pediatric Emergency Care Applied Research Network (PECARN) has developed robust tools for assessing blunt head trauma in children. A 10-year-old boy presents to the emergencydepartment (ED) after a high-speed motor vehicle collision. Case Scenario: What would you do? High Risk (>12.1%
Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management: The SABRE Randomized Clinical Trial. JAMA Surg 2024 Guest Skeptic: Dr. Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergencydepartment and a small regional emergencydepartment.
Join hosts Jeff Nusbaum, MD, and Nachi Gupta, MD on this episode of EMplify as they take you through the June 2018 issue of Emergency Medicine Practice: Managing Shoulder Injuries in the EmergencyDepartmentFracture, Dislocation, and Overuse. Displaced proximal humeral fractures: part I. 2014(5):CD007121.
You are the Paediatric doctor on call and receive a call for an incoming patient to the emergencydepartment. 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 emergencydepartment were unsuccessful.
In the UK, as in most developed countries, more patients are presenting to EmergencyDepartments (EDs) with minor illnesses or injuries. Emergencydepartment overcrowding is a complex issue with multiple contributing factors. Simpson et al. of these were felt to be non-urgent attendances. Simpson et al.
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 emergencydepartments. N Engl J Med.
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. J Trauma Acute Care Surg.
A Diagnostic Accuracy Study to Evaluate Standard Rapid Diagnostic Test (RDT) Alone to Safely Rule Out Imported Malaria in Children Presenting to UK EmergencyDepartments. Using quicker diagnostic tools for malarial infection could significantly reduce repeat attendance to emergencydepartments and laboratory time and equipment costs.
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. 61 out of 77 departments responded. Researchers evaluated the questionnaire and discharge plans against pre-defined criteria.
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. Do your research, and always be safe. jps Sources Roberts and Hedges Clinical Procedures in Emergency Medicine. doi:10.1111/acem.12154
John Brown PhD is a Professor of Health Services Research in Ireland who has been studying rural healthcare issues since 2012. There have been many “temporary” rural emergencydepartment closures during the past last year. It was a stepped-wedge reconfiguration of the entire Danish emergency healthcare system.
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.
In this episode we talk to Joseph Mathew, one of the authors of a great new article on a novel technique for tamponade of bleeding related to pelvic fractures. We also cover the oft-misunderstood procedure of retrograde urethrogram (RUG). This is a great locally written article and I’d recommend you check it out!
Case: A 6-year-old boy comes into your emergencydepartment 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.
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Invasive bacterial infection in children with fever and petechial rash in the emergencydepartment: a national prospective observational study. Arch Dis Child.
There are many different types of pneumothorax (PTX), and the management paradigm has shifted in recent years as the research has exploded on this topic. This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the EmergencyDepartment. 2019;86(4):557-564.
AEM July 2018 Guest Skeptics: Dr. 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.
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. Ann Emerg Med. The most common injuries seen in these younger patients are growth plate fractures and ligamentous injuries.
PSA, also referred to as intravenous sedation in this paper, requires considerable resources, including 1:1 nursing observation, and burdens the emergencydepartment (ED). Data were extracted by one researcher and verified by another. Canadian Journal of Emergency medicine. vs. 91.4%; RR 0.93; 95% CI 0.86–1.01,
Case 1 Fussy 1 month old A 1-month-old (ex-34 week premature) infant comes to your emergencydepartment for fussiness. VP Shunt - Courtesy of Cancer Research UK via wikimedia - CC-4.0 - [link] Case courtesy of Paul Simkin, Radiopaedia.org, rID: 30453 Case courtesy of Dr Ruslan Asadov, Radiopaedia.org, rID: 8401.
Kirsty did her residency in North West England and has a PhD in Health Services Research from Sheffield. Case: A 22-year-old patient presents to the emergencydepartment with sudden onset shortness of breath. She takes the oral contraceptive pill and was placed in a below-knee plaster cast for a fibula fracture 2 weeks ago.
This time, Doctors from ‘The Bridge ‘ tell us what is new in the world of paediatric literature… The Bridge: Is a Post Graduate Doctor in Training (PGDiT) -led paediatric research forum in Yorkshire and Humber, UK, with the aim of bridging the gap in research access amongst PGDiT. Am J Emerg Med. 2024.04.053.
A previously well 6-year-old boy is brought into the emergencydepartment 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. A full primary survey is carried out.
6 Periprosthetic fracture Occurs at an estimated rate of 3.5-4.1%. 5 CT if concern for occult fracture. Periprosthetic Fractures Pain prior to injury may point toward underlying pathology like infection, implant loosening, etc. Unified classification system used to describe periprosthetic hip fractures. 10% of patients.
We have teamed up with the team from the EmergencyDepartment at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergencydepartment sees approximately 50,000 presentations per year. Without a clear definition, tailoring research and audit is difficult.
This single-centre prospective study focused on a quality improvement (QI) project to reduce the overuse of chest X-rays (CXR) in paediatric patients with acute asthma exacerbations (AAE) arriving at the emergencydepartment (ED ). Arch Acad Emerg Med. Pediatric Emergency Medical Journal 2023;10(4):109-117.
They were then able to run their planned subgroup analysis and see which variables were important to the research question. It’s undebatable that the authors have applied rigorous methodology to address this important research question. Each study was weighted proportionate to its contribution to the analysis. used IgE testing.
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. The researchers compared children diagnosed via screening with those diagnosed after clinical symptoms appeared. Hemotympanum with a Basilar Skull Fracture.
Strengths: Investigators asked a patient-centered research question. 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. 2010;58(11):2122-2128.
Samina Ali is a pediatric emergency physician, clinician-scientist, and Professor of Pediatrics & Emergency Medicine at the University of Alberta in Edmonton. Her research is focused on improving the assessment and treatment of children’s pain. She used her arms to break her fall sparing her head in the process.
Some are simple comfort measures such as splinting (fracture or sprain), applying cold (acute soft tissue injury) or heat (non-traumatic, non-specific pain), or other targeted non-pharmacology. Long-bone injuries Fracture pain should be addressed immediately with splinting and analgesia. Acad Emerg Med. Pediatr Emerg Care.
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. J Emerg Med. Acad Emerg Med.
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Original clinical studies Distribution and pattern of hand fractures in children and adolescents. Strategies for Managing Impairing Emotional Outbursts. JAMA Pediatr.
The symphony of sounds in the EmergencyDepartment can be overwhelming. It serves as a constant reminder of the high-stakes nature of the work being done here, where lives hang in the balance, and where the ability to navigate the chaos with skill and compassion will define your journey as an emergency physician.
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].
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. In this issue of the Archives , we read a large retrospective study about gastric acid suppression in infancy and the increased risk of fractures. Siebert JN, et al.
This means that we get so much hands-on experience doing procedures like fracture/dislocation reductions, complex laceration repairs, ENT procedures, and advanced eye exams. We get longitudinalexposure to pediatrics with the opportunity to see kids during each emergencydepartment shift.
You are working in the paediatric emergencydepartment of a busy District General Hospital. These centres have a close relationship with their patients, but this does not mean they may not turn up at your emergencydepartment! Kidney transplant recipients have a higher risk of fractures. Any history of injury?
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