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SGEM#420: I get knocked down, but I get up again – do I have a scaphoid fracture?

The Skeptics' Guide to EM

Which clinical features best predict occult scaphoid fractures? He will soon be transitioning out of the US military after […] The post SGEM#420: I get knocked down, but I get up again – do I have a scaphoid fracture? Which clinical features best predict occult scaphoid fractures? Emerg Med J. Emerg Med J. Emerg Med J.

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Preperitoneal Packing Vs Angioembolization: Part 3

The Trauma Pro

In the previous post in this series, I described an early review article summarizing several older studies comparing these two hemorrhage control techniques for pelvic fractures. They separated all patients with acetabular and pelvic ring fractures using ICD-10 codes. AE and PPP have equivalent outcomes.

Fractures 113
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SGEM#451: I’ve Become So Numb – Serratus Anterior Plane Blocks for Rib Fractures

The Skeptics' Guide to EM

Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management: The SABRE Randomized Clinical Trial. He has three left-sided rib fractures on imaging without underlying complications. Background: Rib fractures are a common injury, particularly for those over 65. We have covered rib fractures twice on the SGEM.

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Trauma Resuscitation Updates

RebelEM

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]

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Twisting and Turning - Ankle Injuries in the ED

Taming the SRU

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

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Pediatric Elbow Injuries

Pediatric Emergency Playbook

What am I seeing -- or not seeing -- here? First a refresher on radiographic anatomy of the elbow -- Images courtesy of Radioglypics (Open Access Radiology Education). If you don't see the obvious fracture, you can be "saved" by the sail sign and/or a posterior fat pad. Position of comfort, analgesia, xrays, and now what?

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What Are Potential Complications of a Forceps Delivery?

Pediatric Education

The radiologic evaluation confirmed that these were subcutaneous fat necrosis. Discussion The main outcome of any delivery is to have a healthy mother and healthy child. Subcutaneous fat necrosis of the newborn: a systematic evaluation of risk factors, clinical manifestations, complications and outcome of 16 children.