Taming the SRU

MARCH 11, 2024

It is also important for the emergency physician to ask about previous surgeries on the affected knee, as well as anticoagulation status. CTAs have the added benefit of also further evaluating the surrounding osseus structures for associated fracture.

Dislocations 107

Dislocations Emergency Department Fractures Operations 107

Taming the SRU

MAY 11, 2024

Be careful with fluid resuscitation in renal transplant patients who can be at risk for volume overload. Validity Evidence for a Team-Leading Assessment Tool in Pediatric Emergency Resuscitation Using Video Review (Hartwell et al.) Assessed and provided feedback of pediatric resuscitations based on video review.

Administration 91

Administration Resuscitation Fluid Resuscitation Research 91

EM SIM Cases

NOVEMBER 12, 2022

Stephen Jensen, Brandon Bowdoin, and Kristen Whitworth as well as Spring Lutzen. The trauma will be an open book pelvic fracture with hypotension and a positive FAST. This case as written by Drs. Stephen Jensen is a third-year emergency medicine resident at Spectrum Health Lakeland.

Resuscitation 40

Resuscitation Stroke EKG/ECG Fractures 40

EMDocs

JUNE 25, 2024

Most common traumatic injuries are fractures, TBIs, and thoracic or abdominal injuries. Consider escharotomy if there is any issue with perfusion or neurologic deficit, as well as difficult ventilation in the intubated patient. Calculating fluid resuscitation: Parkland formula: 4 mL X % TBSA X weight in kilograms.

Burns 74

Burns Fluid Resuscitation Resuscitation Poisoning 74

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

Taming the SRU

AUGUST 25, 2023

doxycycline Consider a splint/cast window to allow direct monitoring mainly used for fracture blisters and/or open wounds yet takes away from the strength of the splint/cast Case #3 43yo with FOOSH injury and closed wrist deformity, yet no x-ray machine is available to you Least likely injuries to need an x-ray in a resource-limiting setting?

Seizures 74

Seizures Fractures EKG/ECG Resuscitation 74

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

Don't Forget the Bubbles

JULY 31, 2023

Our team have scoured what’s new (well, mostly new!) Radiographs from children with fractures, or disease processes affecting bone growth, were excluded. 2004) Positive end expiratory pressure during resuscitation of premature lambs rapidly improves blood gases without adversely affecting arterial pressure. Probyn, M.E.,

Rapid Diagnostic Testing 98

Rapid Diagnostic Testing Resuscitation Emergency Department Pediatrics 98

Taming the SRU

SEPTEMBER 15, 2023

Limited availability of radiology-performed US services in certain hospitals, especially overnight Can avoid unnecessary anticoagulation in patients Reduce time in ED to disposition In terms of workflow, when there is suspicion for a DVT, you need to first calculate a Wells’ Score for a DVT If low/moderate risk, can start with a D-dimer prior to committing (..)

CPR 88

CPR Burns Airway Management Wellness 88

Pediatric Emergency Playbook

MARCH 1, 2016

He sustained a femur fracture, splenic laceration, and blunt head trauma – the so-called Waddell’s triad. Resuscitative Pearls Our goal here is damage control. Otherwise, resuscitate, identify the bleeding source, and slow or stop the bleeding with blood products or surgery. Rib fractures on CXR predict pulmonary contusions.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

Taming the SRU

FEBRUARY 23, 2024

Total RBC count (<500 RBCs in last tube), as well as clearance by the last tube (decrease in RBC count by at least 70% by the last tube), can be used to differentiate between traumatic taps and a SAH. If assessing for SAH, xanthochromia may not appear until 12 hours after onset, though may appear after 2-4 hours.

Pediatrics 73

Pediatrics Ultrasounds Fractures Wellness 73

American Medical Compliance

FEBRUARY 28, 2024

CPR (cardio-pulmonary resuscitation) is a technique used to keep victims of sudden cardiac arrest and other emergencies, alive and to prevent brain damage until more advanced medical professionals arrive. The following CPR Refresher Course educates healthcare providers (HCP) on the basic principles of CPR. This will slow tissue death.

CPR 52

CPR Fractures Resuscitation Wellness 52

The Trauma Pro

MAY 2, 2023

Splint to reduce fracture bleeding. Pack well, close and re-establish normal physiology before doing all the final repairs. We are not always as fastidious as we should be because of the universal availability of blood products. Use direct pressure or direct suture ligation for external bleeding. Always watch the temperature.

Blood Transfusions 100

Blood Transfusions Fractures Wellness Resuscitation 100

EM Curious

JULY 8, 2015

US GUIDED ULNAR NERVE BLOCK [BLOG]: Boxer's fracture need a reduction? Well, this may not be completely true. Consider an ultrasound guided ulnar nerve block. Check out the case here and be sure to watch the video tutorial from 5minsono.

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

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 95

Fractures COPD Hospitals Emergency Department 95

RCEM Learning

APRIL 9, 2024

Ensure that you have a solid understanding of the core subjects, including emergency medicine, clinical skills, critical care, resuscitation, and trauma management. Take care of your physical and mental well-being, and ensure you get adequate rest and relaxation.

Infectious Diseases 52

Infectious Diseases Airway Management Dislocations Poisoning 52

Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. IOs can be used both for resuscitation, medication administration, and for laboratory testing, but there are a few important considerations. Observe the area for signs of extravasation.

Emergency Department 90

Emergency Department Ultrasounds Administration Burns 90

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 40

Fractures Blood Transfusions Sepsis Operations 40

Mind The Bleep

OCTOBER 17, 2024

Clinically, your enthusiasm for providing maximal quality care needs balanced against rescue practicalities and a hostile environment (very different to your warm, dry resuscitation bay) – the cold makes all veins disappear…and you may be the only clinician responder at the scene. Where, might you say, is the role of the doctor?

Soft Tissue Injuries 52

Soft Tissue Injuries Seizures Ambulance Services Teamwork 52

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. Resuscitate with volume and blood. These are most often due to motor vehicle collisions and falls.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Dr. Smith's ECG Blog

JANUARY 21, 2023

In the resuscitation room, the patient had another seizure that stopped after IV Lorazepam. CT head showed traumatic SAH and small SDH with a traumatic occipital fracture. El-Baba, Dell and McLaren to be intriguing for a series of important concepts that it raises — as well as for a number of equally intriguing unanswered questions.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

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

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

ACEP Now

MARCH 14, 2024

Treatment for burns should focus on fluid resuscitation as appropriate based on your institution’s burn protocol per Brooke, Parkland, Rule of 10s etc. Lastly, vessels can be damaged by internal burns, which may lead to poor perfusion and delayed complications as thrombosis or third spacing. His ECG was unremarkable.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

EB Medicine

MARCH 1, 2019

Nachi: This month’s team parsed through roughly 1200 articles as well as guidelines from the eastern association for surgery in trauma also known as EAST. But don’t be reassured by normal vitals, especially in the young, who may be compensating well despite being quite ill. Nachi: Definitely. Let’s move on to treatment.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

Don't Forget the Bubbles

OCTOBER 2, 2024

A previously well 6-year-old boy is brought into the emergency department at a major trauma centre via HEMS following a road traffic accident, in which he was hit by a car while crossing the road. He is diagnosed with a traumatic brain injury and a fracture to his right tibia and fibula. A full primary survey is carried out.

Administration 49

Administration Outcomes Pediatrics Research 49

EB Medicine

NOVEMBER 1, 2018

Thankfully, that gentleman was successfully resuscitated despite no bystander CPR, and if you listen carefully, we hope to arm you with the tools to do so similarly. Jeff: Vascular injuries include coagulation necrosis as well as thrombosis. In at least one study, the incidence of DVT in hospitalized burn patients was as high as 23%.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Dr. Smith's ECG Blog

JULY 3, 2020

She had multiple rib fractures as well as serious hemorrhage and underwent massive transfusion. She sustained chest wall trauma, including rib fractures with serious bleeding. Consider that the patient in this case was promptly resuscitated in the ED. ng/mL, and an ECG was recorded: There are no P-waves visible.

Blood Transfusions 52

Blood Transfusions EKG/ECG Shock Fractures 52

Taming the SRU

FEBRUARY 22, 2023

STEP-UP Self Physical and Psycological IM-SAFE Illness Medications Stress Alcohol Fatigue Eating Psychological Cognitive Threat/Challenge appraisal: PERCEIVED demands vs. resources Threat appraisal - stress levels excessive, performance impaired – vapor lock (autonomic arousal, tunnel vision, auditory exclusion, loss of time awareness, impaired memory (..)

Hospice 40

Hospice EKG/ECG Wellness Resuscitation 40

Rural Doctors Net

AUGUST 30, 2013

I’d raise here the concept of his ‘anticipated clinical course’ – he’s going to OT and has airway injury that will likely progress – so you might as well intubate on these grounds alone. Sure he’s got a traumatic amputation – your tourniquet has arrested the bleeding, but there may well be more blood loss.

Burns 52

Burns Hospitals Wellness Ambulance Services 52

Pediatric Emergency Playbook

JANUARY 1, 2017

Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well. For children greater than one year who are preverbal, a well performing scale is the FLACC score: Face, Legs, Activity, Cry, Consolability ( Table 3 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 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

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 Psychiatric Wellness 63

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Her rejoinder was “I didn’t think to blow through the nose, but, boy, did I blow between the teeth! ” The nose in Early Modern Expired Air Resuscitation: Early teaching in expired-air resuscitation was three-fold. Few people now remember that a strong early proposal in the move for expired air resuscitation was Mouth to Nose.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40