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Ultrasonography or radiography for suspected pediatric distal forearm fractures. Casey currently splits his time […] The post SGEM#415: Buckle Down for some Ultrasound to Diagnosis Distal Forearm Fractures first appeared on The Skeptics Guide to Emergency Medicine. Reference: Snelling et al. He is also a fully-fledged ultrasonographer.
Background Lidocaine patches, applied over rib fractures, may reduce pulmonary complications in older patients. We aimed to establish whether a definitive randomised controlled trial (RCT) evaluating lidocaine patches in older patients with rib fracture(s) was feasible.
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.
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. Researchers then performed the serratus anterior plane block.
Pereira 2017] If pathologic fractures occur, may be misdiagnosed as non-accidental trauma. [Li Confirm a positive result with either a Fluorescent treponemal antibody absorption ( FTA-ABS) and/or micro hemagglutination test for antibodies to T.Pallidum ( MHA-TP ).
Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. His imaging shows mildly displaced rib fractures of ribs four through seven. Reference: Ramesh S, Ayyan SM, Rath DP, Sadanandan DM.
His CT scan showed extensive cranial fractures, traumatic subarachnoid haemorrhage, and intraparenchymal haemorrhage. About PICSTAR PICSTAR is a trainee-led research network open to all doctors, nurses and allied health trainees within Paediatric Intensive Care. At the scene, his lowest GCS was 5 (E1V2M2).
The authors are given very little print space to fully describe their research idea, their methods, and their results’ significance. Even then, it needs to be taken in context with past, similar research before trickling down to patient care. Aspirin or Low-Molecular-Weight Heparin for Thromboprophylaxis after a Fracture.
They have thinner bones of the skull which makes them more prone to skull fractures. of these had a CT performed 1 (0.2%) had a clinically important TBI (ciTBI) 10 (5.1%) had any TBI on CT 9 (4.6%) had skull fractures Remember to always watch out for NAT ! PECARN is highly sensitive for identifying those with clinically important TBI.
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. There is still room for research in this space.
Identification and Management of Pelvic Fractures in Prehospital and Emergency Department Settings – Journal of Surgical Research — Read on www.journalofsurgicalresearch.com/article/S0022-4804(24)00261-0/fulltext
He lives with autism spectrum disorder and is uncomfortable in X-ray rooms, and you wonder if there is a role for PoCUS to help exclude a fracture. With expert clinical commentary by Dr. Arun Sayal and Research Methodology Hot Take by Dr. Shelley Mcleod.
Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management: The SABRE Randomized Clinical Trial. Interests include information systems and digital health, research and education. He has three left-sided rib fractures on imaging without underlying complications. We have covered rib fractures twice on the SGEM.
Similarly, the Pediatric Emergency Care Applied Research Network (PECARN) has developed robust tools for assessing blunt head trauma in children. For years, adult literature has provided clear guidelines for cervical spine imaging through the NEXUS and Canadian C-spine Rule (CCR) tools. High Risk (>12.1% sensitivity and 99.9%
Apparently this paper was entirely fictional (or perhaps the […] The post Research Roundup (April 2023) appeared first on First10EM. Obviously the study was satire, and did an excellent job in making us laugh, but most satire studies (like those in the Christmas edition of the BMJ) are real studies.
Until we have better research to learn from, I suggest the following: Time is of the essence. Reference: Preperitoneal packing versus angioembolization for the initial management of hemodynamically unstable pelvic fracture: A systematic review and meta-analysis. Is packing “better” than embolization?
Interpreting Research Outcomes with a Little Bathroom Humour You have learned a method for how to read a research paper , and now you are faced with a bunch of outcomes. The researchers should have specified a clear research question or aim. Ultrasonography or radiography for suspected pediatric distal forearm fractures.
Background There is a high rate of surgical fixation of displaced Colles’ type distal radial wrist fractures despite fracture manipulation in the ED. Point-of-care ultrasound has been used to guide ED manipulations but its effect on the quality of fracture reduction or subsequent need for surgical fixation is unknown.
Join hosts Jeff Nusbaum, MD, and Nachi Gupta, MD on this episode of EMplify as they take you through the June 2018 issue of Emergency Medicine Practice: Managing Shoulder Injuries in the Emergency Department Fracture, Dislocation, and Overuse. Conservative interventions for treating middle third clavicle fractures in adolescents and adults.
Should we use ultrasound to diagnose distal forearm fractures in children and adolescents? Distal forearm fractures are common in children and adolescents, but the best method for diagnosing them is still debatable. Ultrasonography or Radiography for Suspected Pediatric Distal Forearm Fractures. N Engl J Med.
Screening looks at patient factors such as age, obesity, and previous VTE, as well as injury risk factors like spine and pelvic fractures and decreased mobility. But the simple truth is that we have no solid research that either supports or condemns the use of active compression devices in patients with known DVT.
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. Ways to get involved?
He has a passion for FOAMed and is the creator of the […] The post SGEM#324: Blow Away, Blow Away, Blow Away – Spirometry for Discharging Older Patients with Rib Fractures first appeared on The Skeptics Guide to Emergency Medicine. Spirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures.
Indication - skeletally mature patients with a radiographically documented femur fracture (hip to knee) Contraindications: Patient refusal Allergy to local anesthetic Infection over site of planned injection Obtunded/uncooperative patient Crush injury No available provider or space Medication: 0.5% Staphylococcus spp., and Pasteurella spp.
Ben has a possible skull fracture and has been intubated, but his oxygen requirement is minimal. Intensive Care Research , 1 (3-4), pp.60-64. You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. A 12-year-old male is being transported by ambulance after a road traffic accident.
” Previous research recognises that long waiting times increase the number of patients who leave the ED before medical review, though much of this is based on the adult population. They also likely align with research by Simpson et al., These patients may be classified as “Did Not Wait” (DNW). and Suastegui et al.
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. Splint in slight flexion and arrange close Hand Surgery follow-up as these injuries require surgical repair.
While trauma, fractures, and crystalline diseases can influence OA, metabolic- disease-associated osteoarthritis is becoming far more prevalent. Research indicates that inflammatory processes associated with metabolic syndrome, obesity, and diabetes play a crucial role in the degeneration of cartilage in OA.
The dueling guidelines conflict in parts, reflecting the fundamental ontological confusion and challenges to effective research on the amorphous syndrome that is ARDS. Progress in ARDS research has been very slow, from a clinical perspective. This looks like the major fracture between the two expert panels.
Radiographs from children with fractures, or disease processes affecting bone growth, were excluded. The researchers delivered premature lambs at 125 days gestation (term being 147 days) and proceeded to intubation and drainage of lung fluid. Despite being 20 years old, this study is one of the driving forces for our guidelines.
This has included performing lumbar punctures, diagnosing acute abdominal aneurysms, acute heart failure, pediatric fractures, retinal detachments and endotracheal tube placement. Background: We have reviewed papers on POCUS many times over the years on the SGEM.
In this episode we talk to Joseph Mathew, one of the authors of a great new article on a novel technique for tamponade of bleeding related to pelvic fractures. We also cover the oft-misunderstood procedure of retrograde urethrogram (RUG). This is a great locally written article and I’d recommend you check it out!
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Distribution and pattern of hand fractures in children and adolescents. Pediatrics. 2023 Apr 5:e2022059244. Arneitz C, et al. Eur J Pediatr. 2023 Apr 5. Pediatrics.
It was inspired by a hot-off-the-presses publication from the Pediatric Emergency Care Applied Research Network (PECARN) focused on clinical decision rules for cervical spine imaging in children. Leonard JR, Jaffe DM, Kuppermann N, Olsen CS, Leonard JC; Pediatric Emergency Care Applied Research Network (PECARN) Cervical Spine Study Group.
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. Researchers evaluated the questionnaire and discharge plans against pre-defined criteria. 61 out of 77 departments responded.
It's a bit of a departure from what we've described above--he mainly goes right at a shaft fracture--but it's the same general idea: As always, these posts are for EDUCATIONAL PURPOSES ONLY. Do your research, and always be safe. Ultrasound-Guided Three-In-One Nerve Block for Femur Fractures. doi:10.1111/acem.12154 doi:10.1111/j.1742-6723.2009.01163.xdoi:10.1097/PEC.0000000000000101
There are many different types of pneumothorax (PTX), and the management paradigm has shifted in recent years as the research has exploded on this topic. Blunt trauma can cause rib fracture or dislocation that may injure the visceral pleura. PPV, rib fractures, and decreased GCS were predictive of conservative management failure [23].
John Brown PhD is a Professor of Health Services Research in Ireland who has been studying rural healthcare issues since 2012. The pre-specified subgroup analyses showed a decrease in in-hospital or 30-day mortality for myocardial infarction, stroke, aortic aneurysm, and major trauma but not for pneumonia, bowel perforation or hip fractures.
The objective was to pilot new and existing measures to capture the perceived needs and expectations of young people attending ED following SH compared with those attending with suspected fractures (SFs). Further research is needed.
The dueling guidelines conflict in parts, reflecting the fundamental ontological confusion and challenges to effective research on the amorphous syndrome that is ARDS. Progress in ARDS research has been very slow, from a clinical perspective. This looks like the major fracture between the two expert panels.
Bill is a professor in-residence at the UCLA School of Medicine in Los Angeles and among many other things, the director of UCLA Emergency Medicine Research Assistance program.
The CCHR only applies to those patients with minor head injury and is not applicable to non-traumatic cases, GCS less than 13, age less than 16 years, coumadin or bleeding disorder or obvious open skull fractures. The CCHR is the most researched CDR in mTBI [3] and ha.
A more inquisitive approach would seek to understand why the educational bargain feels more fractured now despite ACGME work hours being more “protective” than ever before. ” They’re more likely to be found re-formatting and submitting research manuscripts in order to pad their CV.
Over the years following her diagnosis, CT developed an impressive array of complications from the prednisone: hypertension, diabetes, a spinal compression fracture. I will work with you to control your symptoms as best we can and I am open to your knowledge, wisdom, and research.” I think we should focus on symptom relief.
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