The past couple of decades have seen increased access to and ease of using CT scanning for traumatically injured patients. Given that the abdomen is an important source of occult bleeding, routine use of abdominal CT scans has become increasingly common and has predictably yielded many negative studies as well as finding clinically irrelevant abnormalities.
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Journal Review
Validity of Abdominal Exam in Blunt Trauma with Distracting Injuries
Core
Temporomandibular Joint (TMJ) Dislocation
This post discusses TMJ dislocations and the numerous reduction techniques.
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Journal Review
Bed-Up-Head-Elevated Position for Emergent Intubation
Emergent endotracheal intubation has risks of complications including hypoxia, pulmonary aspiration, and prolonged time to intubation. Previous studies from the anesthesiology literature suggests that bed-up head-elevated (BUHE) positioning is associated with improved glottic views and prolonged apnea time. Using this positioning method could lead to decreased complication rates with emergent intubation.
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Core
Recent-Onset Atrial Fibrillation
Recent-onset AF is a common presentation in the ED. In this post we discuss management options, anticoagulation + disposition.
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Journal Review
Irrigation of Cutaneous Abscesses
Irrigation after incision and drainage (I+D) of an abscess in the ED is considered by some sources to be standard care but local practice varies considerably. There are no randomized controlled trials to date that look at the potential benefits of this procedure. Irrigation increases the time required for the procedure and increases pain experienced by the patient.
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Journal Review
Rocuronium or Succinycholine for RSI in TBI
Airway management is a critical part of the management of patients presenting with traumatic brain injury (TBI). Emergency Physicians (EPs) have no ability to change the primary injury once it has occurred and so our focus is on preventing secondary brain injury. Hypoxemia and hypercarbia are major contributors to morbidity and mortality and management must focus on preventing them.
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