Taming the SRU

MAY 22, 2023

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]. As an EM physician, it is important to have an understanding of the spectrum of ankle injuries and how these are appropriately evaluated. Obtain at least 3 views when possible.

Fractures 76

Fractures Dislocations Operations Radiology 76

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 59

Dislocations Fractures Soft Tissue Injuries Outcomes 59

Taming the SRU

MAY 23, 2023

As an EM physician, it is important to have an understanding of the spectrum of foot injuries and how these are appropriately evaluated. fractures of the talar body, talar neck, and calcaneus require high-impact trauma). Gross deformities often suggest fracture or dislocation. nonunion, post-traumatic arthritis or deformity).

Fractures 57

Fractures Dislocations Operations EMS 57

EMDocs

JUNE 3, 2023

How should pelvic fractures be identified in unstable trauma patients? What is the EM physician’s role in the stabilization of unstable pelvic injuries? Pelvic fractures can involve disruptions in any of the bony or ligamentous structures of the pelvic ring. While single-bone fractures can occur, they are far less common.

Fractures 54

Fractures Resuscitation Operations EMS 54

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.

Administration 91

Administration Resuscitation Fluid Resuscitation Research 91

EMDocs

NOVEMBER 16, 2024

We’ll keep it short, while you keep that EM brain sharp. 4 Pain is the most common reason for presentation in the early post operative period. 5 Highest risk of dislocation early in the post operative course due to laxity of the soft tissue after surgery. 6 Periprosthetic fracture Occurs at an estimated rate of 3.5-4.1%.

EMS 76

EMS Dislocations Fractures Operations 76

Emergency Medicine Cases

FEBRUARY 26, 2019

In this main episode podcast we discuss the pitfalls in the diagnosis and management of elbow injuries and answer questions such as: What is an easy way to remember the surgical indications for radial head fractures? Why is it so important to assess for the extensor mechanism on physical exam for patients with olecranon fractures?

Soft Tissue Injuries 52

Soft Tissue Injuries Fractures Operations Dislocations 52

Don't Forget the Bubbles

MAY 17, 2023

Post-operative pain in children: Comparison of pain scores between parents and children. Hegeman EM, et al. Schwindt EM, et al. Distribution and pattern of hand fractures in children and adolescents. J Pediatr Gastroenterol Nutr. 2023 Apr 24. Eosinophilia in children: characteristics, etiology and diagnostic algorithm.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

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. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment.

Soft Tissue Injuries 152

Soft Tissue Injuries Dehydration Fractures Operations 152

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. Per EMS, the patient was found at the bottom of a high voltage line with diffuse burns and amputation of his left forearm.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Taming the SRU

JULY 31, 2024

However, believers in this superstition will perceive crazier shifts if the word is uttered so you probably shouldn’t say it, or use cautiously Full moons have no impact on ED, EMS, or HEMS volumes or acuity. Nice people are not more likely to get cancer.

EKG/ECG 52

EKG/ECG Sepsis Documentation/Coding Stroke 52

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe.

Resuscitation 105

Resuscitation Administration Emergency Department Hospitals 105

EMDocs

SEPTEMBER 21, 2024

We’ll keep it short, while you keep that EM brain sharp. A 17-year-old right hand dominant male with no past medical history comes in complaining that he broke his right finger after being tackled at football practice.

Dislocations 75

Dislocations EMS Fractures Operations 75

RebelEM

MARCH 9, 2023

Assess for blood in the nares or signs of basal skull fracture, including battle signs, raccoon eyes, or hemotympanum. Check that clavicles are intact and that there are no obvious rib fractures or spinal step-offs. Operational criteria for the classification of chronic alcoholics: identification of Wernicke’s encephalopathy.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

In fact, one of my surgeon grandfather's ortho buddies (perhaps with the help of some lunchtime martinis) took a look at the x-rays of my Boxer's Fracture and snapped it back into place without any analgesia or procedural sedation, casted me, and sent me home. Advocacy for Trauma Care and EMS Development. Development of EM Residencies.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

EB Medicine

MARCH 1, 2019

Jeff: And don’t forget to get the crash details from the EMS crew before they depart! As a side note, for anyone taking oral boards in a few months, don’t forget to ask the EMS crew for the details!!! In one RCT, the FAST exam reduced the time from arrival in the ED to operative care by 64% in the setting of trauma.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

Taming the SRU

MARCH 14, 2023

Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. Obtain shunt imaging (“shunt series,” CTH non-con) Shunt series shows no migration of the shunt catheters or fractures of the tubing. The seizure abated with rectal diazepam given by the squad.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Pediatric Emergency Playbook

FEBRUARY 1, 2016

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. The initial impact is the greatest, and will vary depending on the child’s height and what part of his body reaches up to the bumper of the car. J Pediatr Surg.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

RebelEM

JANUARY 24, 2024

Schedule follow up with orthopedics within 1 week for discussion of operative management vs early rehab protocols. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation.J Clin Orthop Relat Res 2012; 470(8): 2268-2273. Bone Joint Surg Am.

Operations 105

Operations Ultrasounds Fractures Outcomes 105

ALiEM

OCTOBER 30, 2024

Case A patient arrives via EMS from the bus station complaining of fever, vomiting, and back pain. A trans-esophageal echocardiogram showed a normal ejection fracture, normal right ventricular function, and no vegetations. Your patient ultimately is diagnosed with a spinal epidural abscess requiring operative care.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

Don't Forget the Bubbles

AUGUST 10, 2023

This is partly because the hands (including fingers) of children & young people have a tendency to fracture without as much compressive force being applied to the bones when compared with adult hands. Discussion (from Orthobullets, Relias media & EM News blog) What does this x-ray show? What should you do with it?

Fractures 52

Fractures Soft Tissue Injuries Emergency Department Operations 52

EB Medicine

JUNE 6, 2019

Nachi: And as a brief aside, before we continue… Missed appendicitis is one of the three most common causes of emergency medicine malpractice lawsuits - with MI and fractures being the other two. C suggests taking a ‘worst first’ approach to forming your differential and guiding your workup.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EMDocs

NOVEMBER 4, 2024

Bhana, MD (EM Resident Physician, University of Massachusetts/UMass Chan Medical School); Clarence Kong, MD (Pain Fellow, Eastern Virginia Medical School – Virginia Health Sciences at Old Dominion University); Mani Hashemi, MD (EM Attending, HCA Florida Mercy Hospital); S.M. Authors: Nikhil B. Most cases abate by one year.

Emergency Department 99

Emergency Department Fractures Burns EMS 99

EMDocs

NOVEMBER 13, 2023

Authors: Mary Hamblen, DO (EM Resident Physician, TX); Justin Hacnik, MD (EM Resident Physician, TX); Katherine Spencer, MD (EM Resident Physician, TX); J.D. 23 BCVI should be suspected with any high-energy trauma or any fractures of the maxilla or mandible. of patients with blunt multisystem trauma. DOI: 10.1097/brs.0000000000002420

Stroke 87

Stroke Radiology Radiology Emergency Department 87

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

They also proved that only expired air resuscitation guaranteed sufficient inflation volumes; that exhaled air was a suitable resuscitating gas; and that the operator would have continuous feedback from each breath. Intracranial placement of a nasotracheal tube after facial fracture: a rare complication. Cover with antibiotic.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40