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We have mentioned the Glasgow Coma Scale in multiple delicious morsels: Minor closed headinjuries in <3 month olds and in the rebaked morsel , Blunt cerebrovascular injury , Cerebral edema in DKA , Pediatric Trauma Pitfalls , and Carbon monoxide poisoning. Predicting outcome in individual patients after severe headinjury.
Background: We have covered headinjuries including concussions multiple times on the SGEM. This has included looking at the Canadian CT Head Rules/Tools ( SGEM#106 , SGEM#266 , and SGEM#272 ). Another core element of emergencydepartment (ED) and pre-hospital care is the assessment for potential spinal injuries [1,2].
risk of C Spine injury) Altered Mental Status (GCS 3-8 or U on AVPU) Abnormal ABCs on exam Focal Neurologic Deficits (paresthesia, numbness, weakness) Not Negligible Risk (2.8% Moral of the Morsel Anatomy Matters: Pediatric patients have unique C-spine anatomy, which predisposes them to different injury patterns than adults.
Susan Kirelik, a concussion specialist and emergency medicine physician, discusses the key points of concussion diagnosis and management from the perspective of the emergency medicine clinician. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study.
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.
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.
Over 1,500 children in EDs, aged 1 to 4 with acute hypoxemic respiratory failure needing hospital admission, across 14 emergencydepartments in Australia and New Zealand were randomly allocated 1:1 to high-flow oxygen therapy OR standard oxygen therapy (approximately 750 children in each group). days compared to 1.50
Westafer serves as the Social Media Editor and a research methodology editor for Annals of Emergency Medicine and an Associate Editor for the NEJM Journal Watch Emergency Medicine. A randomized trial comparing prescribed light exercise to standard management for emergencydepartment patients with acute mild traumatic brain injury.
Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the excellent #FOAMed project called First10EM.com Case: A 21-year-old comes into the emergencydepartment after being knocked […] The post SGEM#272: Take the Money and Run without Getting a CT first appeared on The Skeptics Guide to Emergency Medicine.
Many people access urgent care via the emergencydepartment (ED) resulting in poor patient experience, delays to care and duplication, also causing overcrowding, leading to harm. The data identified pathways with largest impact potential - chest pain, dyspnoea and falls/frailty/headinjury.
Whilst you were busy managing headinjuries and drownings, Ranulf had been out with a group of boys from school this evening. You will be running the show today, and you want to use your preparation time well. b) Emergency thoracotomy Let’s be clear: YOU will not be doing any of this. The trauma call goes out.
She is an emergency physician at Mount Sinai Hospital and a Clinician Scientist and the Deputy Director of the Schwartz-Reisman Emergency Medicine Institute. Case: An 18-year-old female presents to the emergencydepartment (ED) after falling off a moving snowmobile and hitting her head on the ground.
Emergency physicians have earned the right to “re-brand” ourselves as indispensable, money-saving change agents in the health care enterprise. Of course, the bill for any episode of emergencydepartment (ED) care can be substantial, exceeding the billed charges for equivalent care provided in some primary care offices.
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. Unrestrained passengers tend to strike the windshield and dashboard, often sustaining trauma to the head, thorax, and legs.
Abusive headinjury is the most common cause of death from child abuse. Up to 30% of infants with abusive headinjury may be misdiagnosed on initial presentation. Consider surgical causes of forceful vomiting, especially if the child does not look anything other than well. J Emerg Med. Louwers et al.
Aims and Objectives Early identification of patients at higher risk of death and hospital admission is an important problem in emergencydepartments. 0.018 , 0.12] INJURY OF HIP/LEG/KNEE/ANKLE/FOOT 7427 15 653 8.8 HEADINJURY 3493 22 382 10.9 FACIAL INJURY 1555 1 128 8.2 NOSE : INJURY 100 0 2 2 0[0 , 3.7]
AEM April 2022 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Case: A 65-year-old man presents to your emergencydepartment with his wife. He remained completely awake and alert and otherwise appeared well. Date: April 7th, 2022 Reference: Wong et al.
The prevalence of these injuries is estimated at 5.2 per 1000 emergencydepartment attendances in the UK (1). 1) Assessment History of Presenting Complaint: Mechanism of Injury: Determine how the injury occurred (e.g., Enquire about any associated trauma such as headinjuries and fractures.
then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,
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