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EM@3AM: Pneumocephalus

EMDocs

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 120
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Fix that jaw drop: mandible dislocation management

Mount Sinai EM

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! dental extraction, tonsillectomy, general anesthesia (the case I saw had happened during endoscopy) Seizure Spontaneou s ex.

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You don’t need labs or CT scans in children who have recovered after a simple febrile or first time seizure

PEMBlog

Team members and families eagerly await your intervention to halt the seizure and understand its underlying cause. The lack of utility of laboratory testing in children with an unprovoked generalized seizure, or a simple febrile seizure is supported by several observational studies.

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Medical Malpractice Insights: Failure to detect child abuse results in $45 million verdict

EMDocs

Chuck Pilcher, MD, FACEP Editor, Medical Malpractice Insights Failure to detect child abuse results in $45 million verdict Femur fracture missed; no imaging follow-up system in place Facts : A 2 ½ month old infant is brought to the ED by his mother because he is not moving his right leg and cries every time it is touched.

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Grand Rounds Recap 3.8.23

Taming the SRU

mepivacaine (1-3 h) 1% lidocaine +/- epi (2-3h) 0.25% bupivacaine (2-3 h) 0.25-0.5% mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2

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SGEM#266: Old Man Take a Look at the Canadian CT Head Rule I’m a Lot Like You Were

The Skeptics' Guide to EM

He is not on anticoagulation and there is no history of seizures. 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. There are no other external signs of trauma on your exam.

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Mastering Minor Care: Concussion

Taming the SRU

Pay close attention to the head and cervical spine for evidence of injuries that necessitate imaging, such as midline spinal tenderness and/or signs of basilar skull fracture (Table 3). Admission should also be strongly considered in patients with a depressed GCS, post-traumatic seizure(s), or intractable symptoms [2].