The Skeptics' Guide to EM

MARCH 25, 2023

Many small trials have compared the accuracy of POCUS to the “gold standard” of “Radiology-performed ultrasound”. Background: The SGEM has reviewed the use of point of care ultrasound (POCUS) for a variety of conditions in the ED. The literature on POCUS for diagnosing acute biliary disease tends to compare th.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

Taming the SRU

MAY 22, 2023

Abnormal neurovascular findings suggest injury to nearby structures (nerves and blood vessels) from dislocations, bony trauma, or increased compartment pressures. Gross deformities often suggest fracture or dislocation [Image 2]. Impaired ROM can be indicative of dislocation, ligamentous injury, or intra-articular pathology.

Fractures 69

Fractures Dislocations Operations Radiology 69

ALiEM

DECEMBER 22, 2023

Laboratory Data Complete blood count (CBC) : Within normal limits Comprehensive metabolic panel (CMP) : Within normal limits AP Pelvis Radiograph (Figure 1) : “Osteopenia with no acute fractures or dislocation” Case Question: As this patient has osteopenia and is unable to bear weight on her right lower extremity, what injury must be ruled out?

Fractures 64

Fractures Dislocations Academics Radiology 64

Pediatric Emergency Playbook

NOVEMBER 1, 2016

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 not, assume a fracture-dislocation. Position of comfort, analgesia, xrays, and now what? Used with permission.

Pediatrics 52

Pediatrics Fractures Dislocations Radiology 52

Taming the SRU

OCTOBER 1, 2023

Blunt trauma can cause rib fracture or dislocation that may injure the visceral pleura. doi:10.1148/radiology.144.4.7111716 Penetrating wounds may allow air to flow into the pleural space from outside the body or from internal disruption of the visceral pleura. AJR Am J Roentgenol. 1995;165(5):1127-1130. doi:10.2214/ajr.165.5.7572489

Fractures 85

Fractures COPD Hospitals Emergency Department 85

Life in the Fast Lane

MAY 16, 2024

Michael Gibbs MD Adult Ortho Cases 003 Sternal. Adult Orthopedic case interpretation with Carrie Bissell, Aaron Fox, Stephanie Jensen, Kendrick Lim and Olivia Rice

Dislocations 52

Dislocations Radiology Radiology Fractures 52

Life in the Fast Lane

DECEMBER 10, 2023

Michael Gibbs MD Pediatric Ortho Cases 007 December 2022; Elbow injuries. Pediatric Orthopedic case interpretation with Haley Dusek, Danielle Sutton, and Virginia Casey

Pediatrics 52

Pediatrics Dislocations Radiology Radiology 52

EMDocs

JUNE 21, 2023

If thinking TA, share your concern with radiology, which improves sensitivity. A 2013 study found a sensitivity of ~47% for TA of the knee using plain radiographs. Based on the data, a normal x-ray couldn’t rule it out.

Soft Tissue Injuries 68

Soft Tissue Injuries Fractures Dislocations Radiology 68

EMDocs

JUNE 3, 2023

Limb-length discrepancy is not often apparent in pelvic fractures and would be more suggestive of a femoral fracture or dislocation. Assessment of pelvic stability with lateral and anterior compression should be done a maximum of one time so as to not exacerbate damage from the injury. Figure 2: Open book pelvic fracture.

Fractures 54

Fractures Resuscitation Operations EMS 54