Emergency Medicine Journal

SEPTEMBER 27, 2023

A Silver Trauma Review Clinic (STRC) was developed in conjunction with the geriatric ED and multidisciplinary services to improve the post-discharge care of patients with non-operative traumatic injuries. In total, 56 patients were reviewed with vertebral fractures. 71% of presentations were as a result of falls under 2 m.

Operations 75

Operations Fractures Outcomes 75

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. Serratus Anterior Plane Blocks for Rib Fractures in the ED.

Fractures 98

Fractures Ultrasounds Outcomes Research 98

Cook County EM Blog

APRIL 7, 2022

He initially presented to an outside hospital where he was told he had an “ankle” fracture and was splinted with a short leg posterior splint. Mildly displaced oblique fracture involving the proximal fibular metaphysis. Otherwise, most cases require operative repair. The patient was sent for radiographs. J Emerg Med.

Fractures 52

Fractures Operations Hospitals 52

The Trauma Pro

OCTOBER 3, 2023

Many vertebral fractures can be treated non-operatively. So I would like to concentrate on some papers that examined the use of back braces on patients who underwent pedicle screw fixation of their thoracic and/or lumbar spine fractures. Is postoperative bracing after pedicle screw fixation of spine fractures necessary?

Fractures 243

Fractures Dislocations Operations Burns 243

Cook County EM Blog

JUNE 2, 2022

Patient Course: Radiographs demonstrated a displaced, comminuted midshaft fracture of the fourth metacarpal. Orthopedic surgery saw the patient in clinic two weeks later, and given the irreducible fracture, the patient underwent open reduction and percutaneous pinning the next day. Metacarpal fractures: treatment and complications.

Fractures 52

Fractures Soft Tissue Injuries Operations Emergency Department 52

The Trauma Pro

APRIL 26, 2024

In this series, I will review the two major techniques for addressing troublesome bleeding from pelvic fractures. A multi-center trial published in 2015 showed an astounding 32% mortality rate for patients with shock from pelvic fracture. As I continue to preach, going anywhere but the OR is dangerous for the patient.

Fractures 147

Fractures Head Injuries Radiology Radiology 147

EB Medicine

NOVEMBER 1, 2021

and get 20% of all orders at [link] Emergency Department Management of Rib Fractures Author: Patrick Maher, MD Episode Outline: Why rib fractures? and get 20% of all orders at [link] Department Management of Rib FracturesAuthor: Patrick Maher, MDEpisode Outline:* Why rib fractures?*

Fractures 52

Fractures Documentation/Coding Operations Emergency Department 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Background During closed reduction of displaced distal radius fractures, physical examination is used to determine the need for further manipulation before radiographic confirmation and cast application. The secondary outcomes were time to complete reduction and treatment plan at ED discharge (conservative or operative repair).

Fractures 40

Fractures Ultrasounds Emergency Department Operations 40

Mount Sinai EM

AUGUST 13, 2023

Background Hip fractures are a very frequent presentation, even in non trauma centers. Adequate pain control, and early surgical treatment and mobilization are the main goals of hip fracture treatment; to reduce complications including infections, DVT and delirium.

Fractures 100

Fractures Dislocations Operations Ultrasounds 100

Mount Sinai EM

OCTOBER 5, 2023

Causes: Lateral dislocation Anterior dislocation Often due to trauma – direct blow Can break condylar neck w/ dislocation Lateral dislocations often w/ fracture Check for loose or missing teeth! Iatrogenic : ex. dental extraction, tonsillectomy, general anesthesia (the case I saw had happened during endoscopy) Seizure Spontaneou s ex.

Dislocations 130

Dislocations Fractures Seizures Operations 130

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]. traumatic axial loading with calcaneal fractures, pilons, and vertebral compression fractures) [5]. Gross deformities often suggest fracture or dislocation [Image 2].

Fractures 77

Fractures Dislocations Operations Radiology 77

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

Mount Sinai EM

DECEMBER 27, 2022

Illustration by Yvonne Chow The Lisfranc Injury The lisfranc injury is any disruption of the joint and is a spectrum including ligamentous injury, dislocations and fractures. High energy mechanisms, such as MVCs or falls, are more likely to cause fracture-dislocations. Normal Lisfranc joint and ligament.

Dislocations 130

Dislocations Fractures Operations Radiology 130

Taming the SRU

MAY 23, 2023

fractures of the talar body, talar neck, and calcaneus require high-impact trauma). Stress fractures are caused by repetitive microtrauma and stress on the bone, and therefore present with more subacute or chronic symptoms. Gross deformities often suggest fracture or dislocation. RICE), and symptomatic management (e.g.,

Fractures 57

Fractures Dislocations Operations EMS 57

EMDocs

MARCH 2, 2024

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. Patients with open skull fractures should be evaluated by neurosurgery and admitted for observation.

EMS 114

EMS Fractures Seizures Head Injuries 114

The Trauma Pro

DECEMBER 12, 2023

In some hospitals, orthopedics may choose to place a traction pin to provide initial fracture management. A patient may be more rapidly taken to the operating room or interventional radiology if the patient is in the emergency department. Do they need to go to the operating room quickly?

Emergency Department 162

Emergency Department Operations Hospitals Radiology 162

EMDocs

JUNE 3, 2023

How should pelvic fractures be identified in unstable trauma patients? Pelvic fractures can involve disruptions in any of the bony or ligamentous structures of the pelvic ring. Due to the round shape of the pelvic ring, multiple fractures typically occur concurrently. 2 Vertical shear fractures are also unstable.

Fractures 54

Fractures Resuscitation Operations EMS 54

EMDocs

AUGUST 12, 2023

Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement. Inoculation usually occurs by penetrating injury , which seeds the tendon sheath. Unrecognized or persistent infection can lead to necrosis of the tendon. There are no extensor tendon sheaths (A) in the hand.

EMS 69

EMS Fractures Operations Ultrasounds 69

ACEP Now

MAY 4, 2023

Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). The chest X-ray showed multiple displaced right rib fractures and chest wall subcutaneous emphysema without definitive evidence of a pneumothorax, as well as right lower lobe atelectasis versus contusion (Figure 1). Click to enlarge.) Click to enlarge.) Click to enlarge.)

EMS 52

EMS Fractures Operations Radiology 52

Taming the SRU

MARCH 11, 2024

A careful skin examination is needed to assess for wounds suggestive of an open fracture or traumatic arthrotomy, skin necrosis, or any dimpling or puckering of the skin, as these can indicate an irreducible dislocation that must be reduced in the operating room. mri images from inpatient visit, pulled from ucmc pacs.

Dislocations 107

Dislocations Emergency Department Fractures Operations 107

ACEP Now

OCTOBER 15, 2023

Fracturing the larynx requires considerable force, and the great majority of fractures are from blunt high-velocity trauma. Is there an open neck wound or palpable cartilage fracture? Reconstructive computed tomography can assess the laryngeal framework to avoid missing laryngeal fracture and, hopefully, long-term comorbidities.

Fractures 52

Fractures Dislocations Airway Management Operations 52

ACEP Now

FEBRUARY 11, 2024

The clavicle is one of the most commonly fractured bones in the human body. Every year, approximately 332,000 people in the United States suffer from a clavicular fracture. The clinician should note the fracture site (either via palpable landmark or ultrasound visualization). Click to enlarge.) for the ED clinician.

Ultrasounds 52

Ultrasounds Fractures Emergency Department Hospitals 52

Taming the SRU

JULY 25, 2024

Femoral nerve block case review - morbidity & mortality - community practice - r2 Clinical pathologic case - visual diagnosis - when time matters - operational aspects of stroke care Femoral nerve Block Case Review WITH dr. stolz Why do we care about regional anesthesia, specifically femoral nerve blocks?

Stroke 97

Stroke Fractures Outcomes Operations 97

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

ALiEM

SEPTEMBER 13, 2024

Laboratory Data CT Orbits/Sella w/ IV Contrast : No acute orbital fracture. An emergent ophthalmology consult is needed to plan for operative repair. Visual acuity: able to count fingers. Extraocular movements intact. Ocular pressure deferred. 1 mm superior eyelid laceration. No evidence of retrobulbar hematoma or emphysema.

Emergency Department 64

Emergency Department Academics Hospitals Fractures 64

RCEM Learning

NOVEMBER 28, 2022

Introduction Immediate management Control of haemorrhage Use of pelvic binder REBOA Management of stable VS unstable fracture Management of closed VS open fracture Other injuries Immediate management Coordinated and structured approach (eg. Learning bite Nearly 90% of pelvic fracture bleeding is venous in origin.

Fractures 52

Fractures Blood Transfusions Sepsis Operations 52

EMDocs

SEPTEMBER 9, 2023

The value of ultrasound for detecting hand fractures: A meta-analysis. Open Fracture. Current concepts in the evaluation and treatment of mallet finger injury. Plast Reconstr Surg. 2013;132(4):560e-566e. doi:10.1097/PRS.0b013e3182a0148c 0b013e3182a0148c Zhao W, Wang G, Chen B, et al. Medicine (Baltimore). 2019;98(44):e17823.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

Mind The Bleep

SEPTEMBER 17, 2024

Feel: Palpate the area of the bite to feel for areas of tenderness as this could indicate a fracture or infection. There should be a minimum of 2 views in the plain film, or 3 in the hands if there is a suspicion of a fracture. Comorbidities Diabetes and immunosuppression increase infection risk and severity 11. Regular medications.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

Downeast Emergency Medicine

FEBRUARY 9, 2022

He had an operative repair of his patellar fracture 10 days after his initial visit. ULTRASOUND PEARLS This case highlights an excellent use of musculoskeletal ultrasound for the diagnosis of patellar fracture. Make sure you always scan the opposite extremity to get a sense of your patient’s baseline/normal anatomy.

Ultrasounds 52

Ultrasounds Fractures Operations Emergency Department 52

Taming the SRU

MAY 11, 2024

For mid-shaft femur fractures, traction appears to may reduce blood loss and pulmonary complications, but the available data is very scarce.

Administration 91

Administration Resuscitation Fluid Resuscitation Research 91

American Medical Compliance

FEBRUARY 28, 2024

What You Will Learn Potential radiation hazards Principles to minimize radiation exposure How to safely operate fluoroscopy equipment Techniques to manage radiation dose Current regulatory requirements The types of personal protective equipment to reduce radiation exposure Details Course length: 1 hour.

Radiology 52

Radiology Radiology Fractures Operations 52

Medical Law

NOVEMBER 12, 2021

Lack of properly trained ride operators can lead to negligent operation that causes injuries to guests. Common theme park injuries include: Fractured bones. How Can Theme Park Operators Be Held Accountable for an Understaffed Theme Park? Lack of trained supervision for rides can lead to patrons being hurt.

Soft Tissue Injuries 52

Soft Tissue Injuries Operations Fractures 52

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. 1 The Rise of the Miami BBL An entire industry has emerged around gluteal AFTs in Miami.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

The Skeptics' Guide to EM

MARCH 25, 2023

Do they need surgery, an ERCP or just analgesia and non-operative care? A focused Biliary US in the ED (BUSED) may be all that is required to guide the surgeon’s decision-making for this patient. Background: The SGEM has reviewed the use of point of care ultrasound (POCUS) for a variety of conditions in the ED.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

Don't Forget the Bubbles

MAY 17, 2023

Post-operative pain in children: Comparison of pain scores between parents and children. Distribution and pattern of hand fractures in children and adolescents. Increased fracture risk among children diagnosed with attention- deficit/hyperactivity disorder: a large matched cohort study. J Pediatr Gastroenterol Nutr. Pediatrics.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Pediatric EM Morsels

JUNE 16, 2023

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

Don't Forget the Bubbles

OCTOBER 10, 2024

The study excluded complex nail bed injuries, including those with distal phalanx fractures, germinal matrix injury or pulp lacerations, meaning outcomes are only relevant to simple nail bed injuries. However, in the secondary outcome of parental assessment, nail discard patients had higher median scores.

Emergency Department 75

Emergency Department Outcomes Research Operations 75