The Trauma Pro

OCTOBER 3, 2023

Many vertebral fractures can be treated non-operatively. So I would like to concentrate on some papers that examined the use of back braces on patients who underwent pedicle screw fixation of their thoracic and/or lumbar spine fractures. Is postoperative bracing after pedicle screw fixation of spine fractures necessary?

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Fractures Operations Dislocations Burns 263

Cook County EM Blog

APRIL 7, 2022

He initially presented to an outside hospital where he was told he had an “ankle” fracture and was splinted with a short leg posterior splint. Mildly displaced oblique fracture involving the proximal fibular metaphysis. Otherwise, most cases require operative repair. The patient was sent for radiographs. J Emerg Med.

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Fractures Operations Hospitals 52

Cook County EM Blog

JUNE 2, 2022

Patient Course: Radiographs demonstrated a displaced, comminuted midshaft fracture of the fourth metacarpal. Orthopedic surgery saw the patient in clinic two weeks later, and given the irreducible fracture, the patient underwent open reduction and percutaneous pinning the next day. Metacarpal fractures: treatment and complications.

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Fractures Soft Tissue Injuries Operations Emergency Department 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Background During closed reduction of displaced distal radius fractures, physical examination is used to determine the need for further manipulation before radiographic confirmation and cast application. The secondary outcomes were time to complete reduction and treatment plan at ED discharge (conservative or operative repair).

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Fractures Ultrasounds Emergency Department Operations 40

EB Medicine

NOVEMBER 1, 2021

and get 20% of all orders at [link] Emergency Department Management of Rib Fractures Author: Patrick Maher, MD Episode Outline: Why rib fractures? and get 20% of all orders at [link] Department Management of Rib FracturesAuthor: Patrick Maher, MDEpisode Outline:* Why rib fractures?*

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Fractures Documentation/Coding Operations Emergency Department 52

Mount Sinai EM

AUGUST 13, 2023

Background Hip fractures are a very frequent presentation, even in non trauma centers. Adequate pain control, and early surgical treatment and mobilization are the main goals of hip fracture treatment; to reduce complications including infections, DVT and delirium.

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Fractures Dislocations Operations Ultrasounds 100

Mount Sinai EM

OCTOBER 5, 2023

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

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Dislocations Fractures Seizures Operations 130

Taming the SRU

MAY 22, 2023

Ankle fractures are the third most common fracture in the ED [2] and more than 20,000 patients are seen in the ED for ankle sprains each day [3]. traumatic axial loading with calcaneal fractures, pilons, and vertebral compression fractures) [5]. Gross deformities often suggest fracture or dislocation [Image 2].

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Fractures Dislocations Operations Radiology 69

EMDocs

MARCH 2, 2024

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.

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EMS Fractures Seizures Head Injuries 113

Mount Sinai EM

DECEMBER 27, 2022

Illustration by Yvonne Chow The Lisfranc Injury The lisfranc injury is any disruption of the joint and is a spectrum including ligamentous injury, dislocations and fractures. High energy mechanisms, such as MVCs or falls, are more likely to cause fracture-dislocations. Normal Lisfranc joint and ligament.

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Dislocations Fractures Operations Radiology 130

Taming the SRU

MAY 23, 2023

fractures of the talar body, talar neck, and calcaneus require high-impact trauma). Stress fractures are caused by repetitive microtrauma and stress on the bone, and therefore present with more subacute or chronic symptoms. Gross deformities often suggest fracture or dislocation. RICE), and symptomatic management (e.g.,

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Fractures Dislocations Operations EMS 55

RebelEM

JANUARY 24, 2024

Schedule follow up with orthopedics within 1 week for discussion of operative management vs early rehab protocols. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation.J Clin Orthop Relat Res 2012; 470(8): 2268-2273. Bone Joint Surg Am.

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Operations Ultrasounds Outcomes Fractures 74

The Trauma Pro

DECEMBER 12, 2023

In some hospitals, orthopedics may choose to place a traction pin to provide initial fracture management. A patient may be more rapidly taken to the operating room or interventional radiology if the patient is in the emergency department. Do they need to go to the operating room quickly?

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Emergency Department Operations Hospitals Radiology 162

EMDocs

AUGUST 12, 2023

Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement. Inoculation usually occurs by penetrating injury , which seeds the tendon sheath. Unrecognized or persistent infection can lead to necrosis of the tendon. There are no extensor tendon sheaths (A) in the hand.

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EMS Fractures Operations Ultrasounds 69

ACEP Now

MAY 4, 2023

Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). The chest X-ray showed multiple displaced right rib fractures and chest wall subcutaneous emphysema without definitive evidence of a pneumothorax, as well as right lower lobe atelectasis versus contusion (Figure 1). Click to enlarge.) Click to enlarge.) Click to enlarge.)

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EMS Fractures Operations Ultrasounds 52

ACEP Now

OCTOBER 15, 2023

Fracturing the larynx requires considerable force, and the great majority of fractures are from blunt high-velocity trauma. Is there an open neck wound or palpable cartilage fracture? Reconstructive computed tomography can assess the laryngeal framework to avoid missing laryngeal fracture and, hopefully, long-term comorbidities.

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Fractures Dislocations Airway Management Operations 52

Taming the SRU

MAY 11, 2024

For mid-shaft femur fractures, traction appears to may reduce blood loss and pulmonary complications, but the available data is very scarce.

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Administration Resuscitation Research Fluid Resuscitation 81

Emergency Medicine Cases

FEBRUARY 26, 2019

In this main episode podcast we discuss the pitfalls in the diagnosis and management of elbow injuries and answer questions such as: What is an easy way to remember the surgical indications for radial head fractures? Why is it so important to assess for the extensor mechanism on physical exam for patients with olecranon fractures?

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Soft Tissue Injuries Fractures Operations Dislocations 52

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. 1 The Rise of the Miami BBL An entire industry has emerged around gluteal AFTs in Miami.

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Emergency Department Operations Ultrasounds Hospitals 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.

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Fractures Blood Transfusions Sepsis Operations 52

EMDocs

SEPTEMBER 9, 2023

The value of ultrasound for detecting hand fractures: A meta-analysis. Open Fracture. Current concepts in the evaluation and treatment of mallet finger injury. Plast Reconstr Surg. 2013;132(4):560e-566e. doi:10.1097/PRS.0b013e3182a0148c 0b013e3182a0148c Zhao W, Wang G, Chen B, et al. Medicine (Baltimore). 2019;98(44):e17823.

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EMS Fractures Soft Tissue Injuries Ultrasounds 77

American Medical Compliance

FEBRUARY 28, 2024

What You Will Learn Potential radiation hazards Principles to minimize radiation exposure How to safely operate fluoroscopy equipment Techniques to manage radiation dose Current regulatory requirements The types of personal protective equipment to reduce radiation exposure Details Course length: 1 hour.

Radiology 52

Radiology Radiology Fractures Operations 52

Downeast Emergency Medicine

FEBRUARY 9, 2022

He had an operative repair of his patellar fracture 10 days after his initial visit. ULTRASOUND PEARLS This case highlights an excellent use of musculoskeletal ultrasound for the diagnosis of patellar fracture. Make sure you always scan the opposite extremity to get a sense of your patient’s baseline/normal anatomy.

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Ultrasounds Fractures Operations Emergency Department 52

Medical Law

NOVEMBER 12, 2021

Lack of properly trained ride operators can lead to negligent operation that causes injuries to guests. Common theme park injuries include: Fractured bones. How Can Theme Park Operators Be Held Accountable for an Understaffed Theme Park? Lack of trained supervision for rides can lead to patrons being hurt.

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Soft Tissue Injuries Operations Fractures 52

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe.

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Resuscitation Administration Emergency Department Hospitals 102

The Skeptics' Guide to EM

MARCH 25, 2023

Do they need surgery, an ERCP or just analgesia and non-operative care? A focused Biliary US in the ED (BUSED) may be all that is required to guide the surgeon’s decision-making for this patient. Background: The SGEM has reviewed the use of point of care ultrasound (POCUS) for a variety of conditions in the ED.

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Ultrasounds Emergency Department Dislocations Radiology 52

Pediatric EM Morsels

JUNE 16, 2023

Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment.

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Soft Tissue Injuries Dehydration Fractures Operations 152

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane).

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Sepsis Administration Documentation/Coding Fractures 84

ACEP Now

MARCH 14, 2024

In our case, the patient had a CT of the head, cervical spine, and chest, abdomen, and pelvis with intravenous contrast demonstrated a C2, C7 compression fracture with significant bowel edema (Figure 4), and was taken to the operating room for left arm disarticulation, left below knee amputation and right above knee amputation.

Burns 52

Burns Fluid Resuscitation EKG/ECG Operations 52

ETM Course

JULY 30, 2015

Key points to remember about traumatic epistaxis are: Exercise caution inserting packing devices into patients with suspected facial or base of skull fractures. This requires operative repair, so refer intermittent heavy bleeders to ENT early.

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Fractures Operations 52

Taming the SRU

NOVEMBER 3, 2023

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. Serratus Anterior Plane Blocks for Rib Fractures in the ED.

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Fractures Ultrasounds Outcomes Research 88

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.

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Fractures Resuscitation Operations EMS 54

RebelEM

MARCH 9, 2023

Assess for blood in the nares or signs of basal skull fracture, including battle signs, raccoon eyes, or hemotympanum. Check that clavicles are intact and that there are no obvious rib fractures or spinal step-offs. Operational criteria for the classification of chronic alcoholics: identification of Wernicke’s encephalopathy.

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Psychiatric Emergency Department Documentation/Coding Fractures 52

Northwestern EM Blog

APRIL 25, 2022

X - ray : Many times, next step will be to get an X-ray to look for associated fractures. Definitive treatment is joint wash out in the Operating Room. It provides additional information about any associated fractures. It is important to note that the absence of these findings does not rule out a traumatic arthrotomy.

Soft Tissue Injuries 52

Soft Tissue Injuries Fractures Sepsis Documentation/Coding 52

Taming the SRU

JANUARY 29, 2024

Notable Diagnostics CBC : unremarkable, BMP : unremarkable X-ray imaging of the left hand, wrist, and forearm: chronic degenerative changes without acute fracture or bony abnormality. The remainder of the physical examination is unremarkable.

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Emergency Department Hospitals Fractures Operations 82

Cook County EM Blog

MARCH 20, 2023

X-rays showed radiopaque foreign bodies confined to the distal thumb without fracture. There were no signs of infection, compartment syndrome, tissue necrosis, or limb ischemia. Orthopedics was consulted and recommended outpatient follow up in several days.

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Documentation/Coding Fractures Operations Research 52

PHEM Cast

APRIL 18, 2016

Spinal fractures occur in 2% of all major trauma. Unstable spinal fractures occur in all major trauma 0.7%. Hauwald, 2002 A co-operative patient does not require immobilization unless their conscious level deteriorates. Remember this when you get on scene – 98% of patients will not have a spinal injury.

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Fractures Operations Administration Shock 40