Snow day for the Cooper EM Residents! Instead of today's conference pearls we finish out our trauma/orthopedic module from January with a high yield summary of clinically useful hand pearls from our awesome new hand surgeon Dr. Nicole Jarrett's lecture!
What's with the empty conference room? This week the Cooper EM Residents attended Resident Wellness Conference in Philadelphia, so today's content is from a lecture from November's module "Acute Signs and Symptoms" Enjoy!
Your patient in the Emergency Department has a Zone II or Zone III finger amputation which requires primary closure of the wound prior to discharge with appropriate outpatient follow up. However, a protruding piece of bone often prevents closure of the skin flap and requires trimming by using a rongeur. While this process is typically carried out by an orthopedic or hand surgical consultant, this post aims to introduce the use of a ronguer during management of finger amputation in the Emergency Department.
This post aims to shine a light on a possibly emerging use of bedside ultrasound. While this is far from being recommended as a viable method of intubation during RSI in an Emergency Department, knowledge that ongoing research evaluating the use of ultrasound-guided tracheal intubation (UGTI) exists can only serve to enhance one's understanding of the progression of ultrasound in medicine.
Case: 43 year old woman presents to Emergency Department after falling from height of second-story window after locking herself out of the house. Patient reports falling onto her left hip. On physical exam, no leg length discrepancy and no bony tenderness to palpation of left hip. The patient cannot move her left lower extremity at the hip and has significant pain with minimal passive range of motion.
High-yield review of recent literature in Emergency Medicine: Kupas F et al. "Glasgow Coma Scale Motor Component ("Patient Does Not Follow Commands") Performs Similiarly to Total Glasgow Coma Scale in Predicting Severe Injury in Trauma Patients." Annals of Emergency Medicine. December 2016.