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 161

Pediatrics Blood Transfusions EMS Fractures 161

Taming the SRU

FEBRUARY 24, 2024

ENRICH Trial - the leadership journey - EMS grand rounds - r4 capstone - r1 clinical knowledge - pediatric lecture ENRICH Trial WITH visiting professor Dr. david wright ICH makes up only 10-15% of all strokes yet has a higher mortality than ischemic strokes and SAH Current 2022 AHA/ASA guidelines for spontaneous ICH (prior to ENRICH Trial) minimally-invasive (..)

Leadership 92

Leadership EMS Pediatrics Stroke 92

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. J Pediatr Surg. 2001;36(2):373. Pediatr Emerg Care.

Shock 300

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 300

EB Medicine

NOVEMBER 3, 2022

(Table 3) Prehospital Care What do our EMS colleagues need to keep in mind when transporting a child with an ocular injury? Orbital fractures: What should we be looking for? Table 3)Prehospital Care* What do our EMS colleagues need to keep in mind when transporting a child with an ocular injury?* How can they help us in the ED?

Pediatrics 52

Pediatrics Fractures EMS Outcomes 52

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

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. Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED.

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 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

The Skeptics' Guide to EM

DECEMBER 17, 2022

Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. EMS have already splinted an obvious mid-shaft femoral fracture, but he continues to be tachycardic and hypotensive.

Blood Transfusions 52

Blood Transfusions Fractures EMS Hospitals 52

Taming the SRU

OCTOBER 16, 2024

Amputations Distal to DIP may require revision amputation, which is in the purview of EM physicians. Patients are unable to actively flex their DIP and x-ray imaging often will reveal and avulsion fracture. X-ray imaging should be obtained to evaluate for avulsion fracture. Antibiotics are not indicated.

Airway Management 71

Airway Management Fractures CDC Pediatrics 71

RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below). to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 137

Stroke Outcomes Hospitals Administration 137

PHEM Cast

JULY 27, 2021

The Sonosite website has some excellent resources, which you can filter according to specialty, including prehospital using ‘EMS/Air Med/Ambulance’. The radiopaedia website is an amazing resource for all things imaging. Their section on POCUS is here. Kenji Inaba.

Ultrasounds 52

Ultrasounds Fractures Resuscitation EMS 52

Don't Forget the Bubbles

MAY 17, 2023

Hegeman EM, et al. Schwindt EM, et al. Early Antibiotic Use and Neonatal Outcomes Among Preterm Infants Without Infections. Distribution and pattern of hand fractures in children and adolescents. Osteomyelitis in Sickle Cell Anemia: Does Age Predict Risk of Salmonella Infection? Pediatr Infect Dis J. 2023 Apr 18.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

ACEP Now

OCTOBER 30, 2023

One case report highlighted an unfortunate outcome from aspiration pneumonia, later found to be due to crayons rather than the expected culprits such as food, secretions, or beverages. With this model, there will hopefully be improved patient satisfaction and better outcomes. EM Resident. Open Access Emerg Med. 2023;50(1):58–59.

Sexual Assault 98

Sexual Assault Teamwork Outcomes Dehydration 98

EMDocs

NOVEMBER 16, 2024

We’ll keep it short, while you keep that EM brain sharp. 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. Initial vital signs include T 36.8,

EMS 75

EMS Dislocations Fractures Operations 75

RebelEM

MAY 25, 2023

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Taming the SRU

DECEMBER 6, 2023

ems grand rounds: southwest ohio protocol updates WITH dr. weekley Ideally, medications will be administered IV or IO, therefore endotracheal tube drug administration will be de-emphasized. If there is no improvement in 20 minutes, EMS will call medical control regarding further decisions. Remember who you are and who you represent.

Leadership 56

Leadership Stroke Airway Management Administration 56

The Skeptics' Guide to EM

APRIL 8, 2023

The main outcome was the adjusted odds ratio for in-hospital mortality and hazard ratio for 30-day mortality with some pre-specified subgroups. The reconfiguration included the centralisation of hospitals and the establishment of emergency departments with specialists present around the clock.

Stroke 55

Stroke Emergency Department Academics COPD 55

Don't Forget the Bubbles

NOVEMBER 6, 2024

Edwards EM, et al. Palpable signs of skull fractures on physical examination and depressed skull fractures or traumatic brain injuries on CT in children. Association of empiric antibiotic selection and clinical outcomes in hospitalised children with severe orbital infections: a retrospective cohort study. Pediatrics.

Pediatrics 59

Pediatrics Sepsis Fractures Hospitals 59

RebelEM

APRIL 29, 2024

Given AHA guidelines recommend early epinephrine administration in cardiac arrest, obtaining access is imperative for resuscitative efforts ( 9) When evaluating over 300,000 out-of-hospital cardiac arrests, a meta-analysis found no significant change in primary outcomes when IV and IO access were compared ( 10 ).

Resuscitation 105

Resuscitation Administration Emergency Department Hospitals 105

EM Curious

JULY 8, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Part 1 here.

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

RebelEM

JANUARY 30, 2023

Heterogeneity (I 2 ) for the primary outcome was 69%, representing a moderate value. Of particular note, subjective outcomes are particularly prone to bias in an open-label trial. vs. 91.4%; RR 0.93; 95% CI 0.86–1.01, 1.01, I2 = 69%, low certainty) Fewer adverse events occurred in the IAL group compared to the PSA group.

Dislocations 59

Dislocations Outcomes Emergency Department Research 59

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

In an attempt to improve resource utilization, emergency department length of stay, limit cost and improve outcomes, there have been multiple Clinical Decision Rules (CDRs) created to help guide clinicians in their decision-making process. We have covered the CCHR on the SGEM with the EM Swami and Dr. Emily Junck back on SGEM#106.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

The Skeptics' Guide to EM

JULY 17, 2018

He is also the CME editor for Academic Emergency Medicine Case: You’re working in a small rural emergency department when a seven-year-old girl comes in by EMS with a head injury. Corey Heitz is an emergency physician in Roanoke, Virginia. Her father was teaching her how to bike and he got a little ambitious and sent her down a small hill.

Pediatrics 52

Pediatrics Head Injuries Academics Emergency Department 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. Trauma CTs showed a "mildly displaced sternal fracture and a small retrosternal hematoma." He was intubated for altered mental status.

EKG/ECG 107

EKG/ECG Wellness Fractures Hospitals 107

EM Curious

JULY 1, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. I would definitely give it a read.

EMS 52

EMS Ultrasounds EKG/ECG Fractures 52

The Skeptics' Guide to EM

APRIL 20, 2019

Talk Trauma is a two-day conference for nurses, allied health and EMS professionals involved in providing care for the adult and paediatric trauma patient. Case: A 52-year-old man presents to the emergency department via EMS after a motor vehicle collision while driving home from the city. You suspect he has been drinking.

Emergency Nursing 40

Emergency Nursing Sepsis EMS Fractures 40

Pediatric Education

APRIL 16, 2023

The cause is felt to be repetitive overload of the patella, knee and tibial structures, along with potential alignment problems, tight tissue and muscle imbalances, which may cause strain and small avulsion fractures of the tibial tuberosity. The outcomes of cushioning devices such as shoe inserts are inconclusive. Curr Opin Pediatr.

Pediatrics 40

Pediatrics Outcomes Fractures EMS 40

EM Curious

JULY 11, 2015

Case by Sean Dyer PGY-3 EM Resident; Peer Reviewed by Dr. Christopher Hogrefe, Assistant Professor in Emergency Medicine at Northwestern University Feinberg School of Medicine The Case A 32 y/o male presents with wrist pain after being involved in a motor vehicle collision this afternoon. References: Sherman, S.

Dislocations 52

Dislocations Emergency Department Fractures Outcomes 52

The Skeptics' Guide to EM

JULY 23, 2022

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.

Fractures 52

Fractures Pediatrics Outcomes Emergency Department 52

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!!! Nachi: Perfect, so that sums up treatment, next we have one special circumstance to discuss: sternal fractures.

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

Taming the SRU

FEBRUARY 22, 2023

doing the little things right, with the understanding that small gains are additive, and that details can be the difference between a good outcome and a poor one. Lesson 11 Find what you love to do and surround yourself with people who make you better at doing it.

Hospice 40

Hospice EKG/ECG Wellness Resuscitation 40

RebelEM

JANUARY 24, 2024

Wallace 2011 ) If addressed early and appropriately, most patients have good self-reported long-term outcomes regardless of the treatment modality Links Orthobullets: Achilles Tendon Rupture Resources: Sheth U et al. Orthop J Sports Med. 2015; 3(4): PMID: 26665055 Post Peer Reviewed By: Salim R.

Operations 105

Operations Ultrasounds Outcomes Fractures 105

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

EMDocs

JULY 3, 2023

Authors: Mikalah Ward, MD (EM Resident Physician, University of Kentucky); Susan Owens, MD (EM Attending Physician, University of Kentucky) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Introduction SAH has the potential for rapid progression and devastating outcomes.

Seizures 85

Seizures Stroke Outcomes EMS 85

RebelEM

MAY 22, 2023

saline Outcomes: Primary: Improvement in pain, measured on a 0 to 10 pain scale from baseline to 60 minutes later Secondary: Use of additional medication for the treatment of pain at any time during the ED course Percentage of patients who failed to achieve clinically important improvement in pain (<1.3)

Administration 97

Administration Emergency Department Dislocations Outcomes 97