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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.
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%
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.
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.
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.
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.
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.
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.
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,
[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.
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].
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.
The post EM Quick Hits 30 Scaphoid Fracture, Therapeutic Hypothermia, HEADS-ED, Pelvic Trauma, Kratom, Femoral Lines appeared first on Emergency Medicine Cases.
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.
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.
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.
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.
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?
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.
The patient has a history of a provoked PE after a tib-fib fracture 15 years ago. PMID: 39487597 REBEL EM: D-Dimer in High Risk PE: A Gamble Worth Taking? Age-Adjusted D-Dimer: Core EM: Age Adjusted D-Dimer in PE The ADJUST-PE Trial REBEL EM: PEGeD Study Is It Safe to Adjust the D-Dimer Threshold for Clinical Probability?
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.
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.
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.
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?
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.
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?
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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