EMS and Fractures - Emergency Care Today

Rebaked Morsel: Pediatric Buckle and Greenstick Forearm Fractures

Pediatric EM Morsels

APRIL 19, 2024

Yes, we’re talking about your clavicular , proximal humeral, supracondylar, lateral condylar , scaphoid and metacarpal fractures. Today, we want to focus on a couple of our good friends, buckle and greenstick forearm fractures. Pediatric patients have unique bony anatomy and physiology compared to the skeletally mature.

Fractures

Fractures Pediatrics Best Practices Outcomes

Elbow Dislocations

RebelEM

NOVEMBER 6, 2024

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 (..)

Dislocations

Dislocations Fractures Soft Tissue Injuries Outcomes

EM@3AM: Pediatric Osteomyelitis

EMDocs

MARCH 9, 2025

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%

Pediatrics

Pediatrics EMS Infectious Diseases Fractures

Webinars

Bridging Innovation & Patient Care: The Growing Role of AI

MORE WEBINARS

Tibial Tubercle Avulsion Fracture

Pediatric EM Morsels

APRIL 28, 2023

We have previously discussed how the surrounding ligaments and tendon are often stronger than the weakest part of the child’s bone necessitating our vigilance when addressing the pediatric extremity complaint (ex, Ankle Pain , Elbow Injury , Supracondylar Fractures ). Of course, we cannot assume all anterior knee pain is benign.

Fractures

Fractures Pediatrics Operations Wellness

EM Quick Hits 60 Post-Tonsillectomy Hemorrhage, Post-CABG Infections, Bougie Tips, Pelvic Fracture Bleeds, Debriefing: Why, When & How

Emergency Medicine Cases

OCTOBER 22, 2024

Do you learn a lot from EM Cases?

Fractures

Fractures EMS Resuscitation

EM@3AM: Pneumocephalus

EMDocs

MARCH 2, 2024

We’ll keep it short, while you keep that EM brain sharp. A 3 cm scalp laceration is noted, and a CT scan of the head shows a linear nondepressed skull fracture in the area of the laceration without evidence of intracranial hemorrhage. This is considered an open fracture.

EMS

EMS Fractures Seizures Head Injuries

Twists and Turns: Identifying Maisonneuve Fractures in the ED

Taming the SRU

SEPTEMBER 25, 2023

This places a significant responsibility on the EM physician to diagnose and treat fractures. Specifically, EM physicians should be able to recognize fractures that will likely require operative management and facilitate close follow up, such as a Maisonneuve fracture.

Fractures

Fractures Operations Emergency Department EMS

EM@3AM: Thoracic and Lumbar Spine Trauma

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

EMS Fractures Emergency Department Dislocations

EM@3AM: Flexor Tendon Laceration

EMDocs

AUGUST 12, 2023

We’ll keep it short, while you keep that EM brain sharp. The value of ultrasound for detecting hand fractures: A meta-analysis. A 41-year-old male with no significant past medical history presents with a deep hand laceration. The patient states they were cutting an avocado when the knife pierced through and punctured his hand.

EMS

EMS Fractures Operations Ultrasounds

EM@3AM: Traumatic Iritis

EMDocs

JUNE 8, 2024

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]. The post EM@3AM: Traumatic Iritis appeared first on emDOCs.net - Emergency Medicine Education.

EMS

EMS Allergic Reactions Poisoning Emergency Department

Serratus Anterior Plane Blocks for Rib Fractures in the ED

Taming the SRU

NOVEMBER 3, 2023

Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. This topic is important because of the high incidence of rib fractures in trauma patients and their association with increased morbidity and mortality. Ultrasound Med. 41, 2695–2701 (2022). Why do we care? SD 3.28) and 6.5,

Fractures

Fractures Ultrasounds Research Outcomes

Pseudoparalysis of Parrot

Pediatric EM Morsels

JANUARY 19, 2024

[Pereira 2017] If pathologic fractures occur, may be misdiagnosed as non-accidental trauma. [Li The post Pseudoparalysis of Parrot appeared first on Pediatric EM Morsels. Index of Suspicion. Pseudoparalysis of Parrot caused by congenital syphilis. Pediatr Rev. 1997;18(2):63-65.

Infectious Diseases

Infectious Diseases CDC Pediatrics Fractures

Neurogenic Shock in Children

Pediatric EM Morsels

SEPTEMBER 22, 2023

To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Most commonly caused by fracture or dislocation of vertebrae. Never fear. Updated 2022 Mar 3]. In: StatPearls [Internet].

Shock

Shock Pediatrics Dislocations Hyperthermia / Hypothermia

EM Quick Hits 44 Fluids in Pancreatitis, Nasal Fractures, Delirium, DOSE VF, Intimate Partner Violence

Emergency Medicine Cases

NOVEMBER 22, 2022

In this EM Quick Hits podcast: Justin Morgenstern on fluids in pancreatitis, Leeor Sommer on nasal fractures, Christina Shenvi on delirium, Sheldon Cheskes and Rohit Mohindra on Dose VF, and Noor Khatib and Kari Sampsel on intimate partner violence.

Fractures

Fractures EMS Fluid Resuscitation Resuscitation

EM Quick Hits 30 Scaphoid Fracture, Therapeutic Hypothermia, HEADS-ED, Pelvic Trauma, Kratom, Femoral Lines

Emergency Medicine Cases

JULY 13, 2021

The post EM Quick Hits 30 Scaphoid Fracture, Therapeutic Hypothermia, HEADS-ED, Pelvic Trauma, Kratom, Femoral Lines appeared first on Emergency Medicine Cases.

Hyperthermia / Hypothermia

Hyperthermia / Hypothermia Fractures EMS Pediatrics

EM Quick Hits 2 Organophosphate Poisoning, TXA for Hemoptysis, Metacarpal Fracture Rotation, Abdominal Stab Wounds, Pediatric IV Cannulation

Emergency Medicine Cases

FEBRUARY 12, 2019

On this EM Quick Hits podcast we have Emily Austin on organophosphate poisoning, Arun Sayal on malrotation of metacarpal fractures, Andrew Petrosoniak on pitfalls in abdominal stab wound management, Anand Swaminathan on tranexamic acid for non-massive hemoptysis, and Natalie May on pediatric IV cannulation tips and tricks.

Poisoning

Poisoning Fractures Pediatrics EMS

Pseudosubluxation: Rebaked Morsel

Pediatric EM Morsels

MARCH 31, 2023

Loss of cervical lordosis Concerning mechanism Remember: CT will help identify bony injury, however MRI is the better test to assess for ligamentous injury as well as spinal cord injury Below is an example of a Hangman’s Fracture (See Cervical Spine Fractures ). Moral of the Morsel You eyes may deceive you! J Clin Orthop Trauma.

Fractures

Fractures Dislocations Pediatrics Radiology

Rosh Review EM Scholar Monthly Question

RebelEM

SEPTEMBER 18, 2023

Triquetral fractures overview. Triquetral fracture – pooping duck sign. Rezaie, MD (Twitter: @srrezaie ) The post Rosh Review EM Scholar Monthly Question appeared first on REBEL EM - Emergency Medicine Blog. Curr Rev Musculoskelet Med. 2021;14(2):101–106. link] Skalski M. Radiopaedia website.

EMS

EMS Fractures

Closed Head Injury – PECARN for < 3 Months: Rebaked Morsel

Pediatric EM Morsels

MAY 12, 2023

They have thinner bones of the skull which makes them more prone to skull fractures. of these had a CT performed 1 (0.2%) had a clinically important TBI (ciTBI) 10 (5.1%) had any TBI on CT 9 (4.6%) had skull fractures Remember to always watch out for NAT ! PECARN is highly sensitive for identifying those with clinically important TBI.

Head Injuries

Head Injuries Fractures Pediatrics EMS

JJ 13 Regional Nerve Blocks for Hip Fractures

Emergency Medicine Cases

AUGUST 28, 2018

In this EM Cases Journal Jam podcast with Anton Helman, Justin Morgenstern, Rory Spiegel, and special guest Jacques Lee we explore the evidence for femoral nerve blocks and fascia iliaca blocks as well as discuss the practical implementation of them in your ED. Do they decrease opioid use? Are they safe compared to standard pain management?

Fractures

Fractures EMS Wellness

Low Risk Intra-Abdominal Trauma: Rebaked Morsel

Pediatric EM Morsels

MAY 24, 2024

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? The post Low Risk Intra-Abdominal Trauma: Rebaked Morsel appeared first on Pediatric EM Morsels. J Am Coll Surg. 2017;224:449-460. doi:10.1016/j.jamcollsurg.2016.12.041.

Pediatrics

Pediatrics Blood Transfusions EMS Fractures

Rosh Review EM Scholar Monthly Question

RebelEM

AUGUST 17, 2023

A femur fracture A high-riding patella A noncompressible right femoral vein with decreased color flow on Doppler An avulsion fracture of the anterolateral tibial plateau Calcification and bone formation within the thigh muscle FOR THE RIGHT ANSWER CLICK ON THE ROSH REVIEW LOGO BELOW References Abraham MK, Bond MC. Post TW, ed.

EMS

EMS Fractures Emergency Department

Ep 160 Geriatric Trauma 2 Rib Fractures, Pelvic Fractures, Prognostication, Elder Abuse, Discharge Planning

Emergency Medicine Cases

SEPTEMBER 7, 2021

In Geriatric Trauma Part 2 we answer questions such as: what are the indications for transfer to a trauma center in older patients with rib fractures and why? The post Ep 160 Geriatric Trauma 2 Rib Fractures, Pelvic Fractures, Prognostication, Elder Abuse, Discharge Planning appeared first on Emergency Medicine Cases.

Elder Abuse

Elder Abuse Fractures EMS

ALiEM AIR Series | Procedures Module

ALiEM

APRIL 14, 2023

Highlighted Quality Posts: Procedures Site Article Author Date Label Rebel EM Intra Articular Lidocaine vs Sedation in Shoulder Reductions Nordia Matthews, MD 30 Jan 2023 AIR EM Docs Video Laryngoscopy in the ED Cameron Jones, MD 8 Aug 2022 AIR First 10 EM Lacerations: Does closure technique matter?

EMS

EMS Ultrasounds Academics Fractures

POCUS Cases 4 – Distal Radius Fracture Diagnosis and Reduction

Emergency Medicine Cases

JULY 17, 2018

In this month's POCUS Cases Dr. Rob Simard explains the role of POCUS in distal radius fracture diagnosis and reduction, how to troubleshoot finding the echogenic line that represents the shaft of the radius, and the limitations of using POCUS for distal radius fractures.

Fractures

Fractures Ultrasounds EMS

Ep 136 Occult Shoulder Injuries and Proximal Humerus Fractures

Emergency Medicine Cases

FEBRUARY 25, 2020

Which proximal humerus fractures are likely to require surgical management? What are the surgical indications for clavicle fractures? The post Ep 136 Occult Shoulder Injuries and Proximal Humerus Fractures appeared first on Emergency Medicine Cases. What is the best x-ray view to diagnose a sternoclavicular dislocation?

Fractures

Fractures Dislocations Ultrasounds EMS

Ep 189 Commonly Missed and Mismanaged Wrist Injuries

Emergency Medicine Cases

DECEMBER 19, 2023

When it comes to distal radius fractures, how are Colles vs Barton's vs Smith's fractures managed differently in the ED? Matt DiStefano answer such questions as:when should we suspect a DRUJ injury, why is it important to pick up DRUJ injuries in the ED, and how does it change our management?

Fractures

Fractures EMS

Medical Malpractice Insights: Failure to detect child abuse results in $45 million verdict

EMDocs

AUGUST 28, 2023

Chuck Pilcher, MD, FACEP Editor, Medical Malpractice Insights Failure to detect child abuse results in $45 million verdict Femur fracture missed; no imaging follow-up system in place Facts : A 2 ½ month old infant is brought to the ED by his mother because he is not moving his right leg and cries every time it is touched.

Fractures

Fractures Seizures Patient Safety Hospitals

EM Quick Hits 9 Burn Blister Debridement, ECG Cases, Compartment Syndrome, Pediatric Asthma, Spinal Trauma, Motivational Interviewing P2

Emergency Medicine Cases

OCTOBER 8, 2019

The post EM Quick Hits 9 Burn Blister Debridement, ECG Cases, Compartment Syndrome, Pediatric Asthma, Spinal Trauma, Motivational Interviewing P2 appeared first on Emergency Medicine Cases.

Burns

Burns Pediatrics EMS EKG/ECG

Journal Club 4 PoCUS or X-ray for Distal Forearm Fractures

Emergency Medicine Cases

JULY 18, 2023

He lives with autism spectrum disorder and is uncomfortable in X-ray rooms, and you wonder if there is a role for PoCUS to help exclude a fracture. The post Journal Club 4 PoCUS or X-ray for Distal Forearm Fractures appeared first on Emergency Medicine Cases.

Fractures

Fractures Research EMS

Case Report: EMS Says Flail Chest, But Is It?

ACEP Now

MAY 4, 2023

Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). EMS recognized a chest wall deformity with movement of the chest wall, and a splint was devised and taped around his chest for what was suspected to be a flail chest. Discussion FIGURE 5: Chest X-ray OF post open reduction and interior fixation of rib fractures.

EMS

EMS Fractures Operations Radiology

SGEM#273: My Buddy (Tape) for Boxer’s Fractures

The Skeptics' Guide to EM

NOVEMBER 2, 2019

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.

Fractures

Fractures EMS Emergency Department Outcomes

Ep 179 Hand Injuries – Finger Tip Injuries, Jersey Finger, PIP Dislocations, Metacarpal Fractures, Thumb Injuries, Tendon Lacerations

Emergency Medicine Cases

FEBRUARY 28, 2023

The post Ep 179 Hand Injuries – Finger Tip Injuries, Jersey Finger, PIP Dislocations, Metacarpal Fractures, Thumb Injuries, Tendon Lacerations appeared first on Emergency Medicine Cases.

Dislocations

Dislocations Fractures EMS

EM Quick Hits 18 Conservative Management Pneumothorax, Microdosing Buprenorphine, Practical Use of CRITOE, Canadian TIA Score, Pediatric Surviving Sepsis Guidelines, Safety of Peripheral Vasopressors

Emergency Medicine Cases

MAY 5, 2020

The post EM Quick Hits 18 Conservative Management Pneumothorax, Microdosing Buprenorphine, Practical Use of CRITOE, Canadian TIA Score, Pediatric Surviving Sepsis Guidelines, Safety of Peripheral Vasopressors appeared first on Emergency Medicine Cases.

Sepsis

Sepsis Pediatrics EMS Fractures

Medical Malpractice Insights: Back to Basics

EMDocs

JUNE 28, 2023

And listen to your EMS providers and nurses. EMS is called, and he is brought to the ED for a reported “slip and fall” with associated facial abrasions. EMS is called, and he is brought to the ED for a reported “slip and fall” with associated facial abrasions. EM requires a team! Examine the patient.

Documentation/Coding

Documentation/Coding EMS Stroke Patient Safety

Proximal Tibiofibular Joint Dislocation in Children

Pediatric EM Morsels

JULY 7, 2023

Evaluating the limping child , though, requires us to ponder not only the common (ex, Toddler’s Fracture ), but also to be vigilant for the severe (ex, Septic Arthritis ). The post Proximal Tibiofibular Joint Dislocation in Children appeared first on Pediatric EM Morsels. Emerg Med J. 2006 May;23(5):e33. doi: 10.1136/emj.2005.032144.

Dislocations

Dislocations Fractures Pediatrics EMS

Grand Rounds Recap 2.14.24

Taming the SRU

FEBRUARY 24, 2024

Sometimes even the smallest contributions can make the biggest difference in patient experience and overall ED quality. Early recognition and prompt treatment is key. non-invasive positive pressure ventilation and IV nitroglycerin infusion have been shown to reduce morbidity (intubation rates, ICU admission) & mortality.

Leadership

Leadership EMS Pediatrics Stroke

SGEM#324: Blow Away, Blow Away, Blow Away – Spirometry for Discharging Older Patients with Rib Fractures

The Skeptics' Guide to EM

MARCH 27, 2021

He has a passion for FOAMed and is the creator of the […] The post SGEM#324: Blow Away, Blow Away, Blow Away – Spirometry for Discharging Older Patients with Rib Fractures first appeared on The Skeptics Guide to Emergency Medicine. He has a passion for FOAMed and is the creator of the Danish EM platform www.akutmedicineren.dk.

Fractures

Fractures Outcomes Hospitals Emergency Department

Grand Rounds 5.8.24

Taming the SRU

MAY 11, 2024

r1 clinical knowledge - r4 capstone - research grand rounds - the art of em - Community corner - PEM Lecture r1 Clinical knowledge: transplant complications WITH dr. gabor Time-sensitive peri-transplant emergencies: Bleeding fistula- stop the bleed. Flood syndrome- start fluids, give antibiotics, consult surgery.

Resuscitation

Resuscitation Administration Fluid Resuscitation Research

EM Topic – Orthopaedics & Trauma

EMergucate

MAY 17, 2016

– Abdominal Trauma – Ankle & Foot Fractures – Blast Injury – Burns – C-Spine Trauma – Chest Trauma – … Continue reading →

EMS

EMS Burns Fractures

SAEM Clinical Images Series: Back Yard Football Injury

ALiEM

AUGUST 7, 2023

A 10-year-old male with no past medical history presents to the Emergency Department (ED) by EMS for evaluation of an injury sustained while playing tackle football. The patient was forcibly hit by another child against a tree.

Dislocations

Dislocations Academics Fractures Emergency Department

IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

RebelEM

FEBRUARY 24, 2025

just be careful with pelvic fractures or any femoral arterial punctures/ devices. Feb 2023; PMID: 36835888 Peer Reviewed By: Mark Ramzy, DO (X: @ MRamzyDO ), Marco Propersi, DO (X: @Marco_Propersi ) The post IVC Distensibility Index vs Collapsibility Index: Using the Correct Index appeared first on REBEL EM - Emergency Medicine Blog.

Ultrasounds

Ultrasounds Shock Fluid Resuscitation Resuscitation

Occult and Subtle Wrist and Hand Injuries You Don’t Want To Miss

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

Fractures Dislocations EMS Emergency Department

Morel-Lavallée Lesion in Children

Pediatric EM Morsels

JUNE 16, 2023

Arch Orthop Trauma Surg 2013;133(5):635-640.23443527 The post Morel-Lavallée Lesion in Children appeared first on Pediatric EM Morsels. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment.

Soft Tissue Injuries

Soft Tissue Injuries Dehydration Fractures Operations

Rebaked Morsel: Pediatric Buckle and Greenstick Forearm Fractures

Elbow Dislocations

Webinars

Trending Sources

EM@3AM: Pediatric Osteomyelitis

Webinars

Tibial Tubercle Avulsion Fracture

EM Quick Hits 60 Post-Tonsillectomy Hemorrhage, Post-CABG Infections, Bougie Tips, Pelvic Fracture Bleeds, Debriefing: Why, When & How

EM@3AM: Pneumocephalus

Twists and Turns: Identifying Maisonneuve Fractures in the ED

EM@3AM: Thoracic and Lumbar Spine Trauma

EM@3AM: Flexor Tendon Laceration

EM@3AM: Traumatic Iritis

Serratus Anterior Plane Blocks for Rib Fractures in the ED

Pseudoparalysis of Parrot

Neurogenic Shock in Children

EM Quick Hits 44 Fluids in Pancreatitis, Nasal Fractures, Delirium, DOSE VF, Intimate Partner Violence

EM Quick Hits 30 Scaphoid Fracture, Therapeutic Hypothermia, HEADS-ED, Pelvic Trauma, Kratom, Femoral Lines

EM Quick Hits 2 Organophosphate Poisoning, TXA for Hemoptysis, Metacarpal Fracture Rotation, Abdominal Stab Wounds, Pediatric IV Cannulation

Pseudosubluxation: Rebaked Morsel

Rosh Review EM Scholar Monthly Question

Closed Head Injury – PECARN for < 3 Months: Rebaked Morsel

JJ 13 Regional Nerve Blocks for Hip Fractures

Low Risk Intra-Abdominal Trauma: Rebaked Morsel

Rosh Review EM Scholar Monthly Question

Ep 160 Geriatric Trauma 2 Rib Fractures, Pelvic Fractures, Prognostication, Elder Abuse, Discharge Planning

ALiEM AIR Series | Procedures Module

POCUS Cases 4 – Distal Radius Fracture Diagnosis and Reduction

Ep 136 Occult Shoulder Injuries and Proximal Humerus Fractures

Ep 189 Commonly Missed and Mismanaged Wrist Injuries

Medical Malpractice Insights: Failure to detect child abuse results in $45 million verdict

EM Quick Hits 9 Burn Blister Debridement, ECG Cases, Compartment Syndrome, Pediatric Asthma, Spinal Trauma, Motivational Interviewing P2

Journal Club 4 PoCUS or X-ray for Distal Forearm Fractures

Case Report: EMS Says Flail Chest, But Is It?

SGEM#273: My Buddy (Tape) for Boxer’s Fractures

Ep 179 Hand Injuries – Finger Tip Injuries, Jersey Finger, PIP Dislocations, Metacarpal Fractures, Thumb Injuries, Tendon Lacerations

EM Quick Hits 18 Conservative Management Pneumothorax, Microdosing Buprenorphine, Practical Use of CRITOE, Canadian TIA Score, Pediatric Surviving Sepsis Guidelines, Safety of Peripheral Vasopressors

Medical Malpractice Insights: Back to Basics

Proximal Tibiofibular Joint Dislocation in Children

Grand Rounds Recap 2.14.24

SGEM#324: Blow Away, Blow Away, Blow Away – Spirometry for Discharging Older Patients with Rib Fractures

Grand Rounds 5.8.24

EM Topic – Orthopaedics & Trauma

SAEM Clinical Images Series: Back Yard Football Injury

IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

Occult and Subtle Wrist and Hand Injuries You Don’t Want To Miss

Morel-Lavallée Lesion in Children

Stay Connected