Pediatric Education

OCTOBER 22, 2023

Patient Presentation A 2-week-old female came to clinic for her 2 week well child appointment. Her parents felt that she was doing well with feeding every 2-3 hours with many urine and stool diapers per day. The radiologic evaluation confirmed that these were subcutaneous fat necrosis. Her mild jaundice had disappeared.

Radiology 52

Radiology Radiology Fractures Pediatrics 52

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

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED? ETT onto a fiberoptic scope.

CPR 88

CPR Burns Airway Management Wellness 88

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. Blunt trauma can cause rib fracture or dislocation that may injure the visceral pleura. 89% of patients with PTX under this cutoff were successfully observed.

Fractures 94

Fractures COPD Hospitals Emergency Department 94

Don't Forget the Bubbles

JUNE 30, 2023

She has a right parietal-occipital region haematoma, and you think you might be able to feel a step – you’re pretty convinced she has a palpable skull fracture. Well, one study in Kornelson’s systematic review and meta-analysis is interesting. She’s wheeled to radiology. Two IVs go in, one in each antecubital fossa.

Head Injuries 145

Head Injuries Seizures Outcomes Pediatrics 145

PEMBlog

SEPTEMBER 13, 2023

This harm can manifest through the discomfort of blood draws and urine catheterizations, as well as the radiation exposure involved in head CT scans. Fever First, is there a fever in a previously well child between the ages of 6 months and 5 years? Occult trauma Any trauma that is not seen on your physical (e.g.

Seizures 52

Seizures Pediatrics Point-of-Care Testing Wellness 52

EMDocs

JULY 3, 2023

3 Common associated injuries may include skull fractures, intracerebral contusion, cervical spine injuries, and vascular injuries of the head and neck. All patients with concern for SAH need a rapid primary survey to assess the airway, breathing, and circulation as well as a comprehensive neurologic exam to create a baseline for the patient.

Seizures 85

Seizures Stroke Outcomes EMS 85

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

Northwestern EM Blog

DECEMBER 20, 2021

Physical examination should always include an attempt to ambulate the child unless there is an obvious contraindication noted immediately (eg open fracture). Typically well appearing with normal labs, however, this is a diagnosis of exclusion and a septic joint should be ruled out. Affects ages 3-8, males to females 2:1 [3].

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Protocols work well for adults, but trauma in children requires that we exercise our clinical muscles just a bit more. 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. Traumatized children need your full attention.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

PEMBlog

JUNE 5, 2024

Infants can get a cervical spine injury during breech delivery or, unfortunately, during non accidental trauma as well. The most common injuries seen in these younger patients are growth plate fractures and ligamentous injuries. This is the hangman’s fracture, the posterior neural arch of C1 or the pedicles of C2.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Pediatric Emergency Playbook

MARCH 1, 2016

He sustained a femur fracture, splenic laceration, and blunt head trauma – the so-called Waddell’s triad. Adults tolerate hypotension relatively well, and is sufficient until we send them to the OR or interventional radiology suite. Rib fractures on CXR predict pulmonary contusions. He decompensates and needs blood.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. For example, patients with misdiagnosed disease has less RLQ pain and tenderness as well as diminished anorexia, nausea, and vomiting.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

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. Still no pain medicine. 1950s & 1960s Resuscitation Research.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

RebelEM

MAY 25, 2023

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. Ann Emerg Med 2017 [6] This was a retrospective database review of 7521 traumatic brain injury patients SBP target ≥90mmHg resulted in a mortality of 7.8%

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 63

Documentation/Coding Seizures Wellness Psychiatric 63

EMDocs

NOVEMBER 13, 2023

2019) argue against a minimum NIHSS score to trigger the use of CTA, instead purporting that clinical suspicion of acute ischemic stroke presenting within 24 hours of the last known well was sufficient evidence to order the study. 23 BCVI should be suspected with any high-energy trauma or any fractures of the maxilla or mandible.

Stroke 87

Stroke Radiology Radiology Emergency Department 87