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Open Fractures

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Although relatively straightforward, management of open fractures has some minor nuances that are important for EPs to understand.
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Journal Review

Lumbar Puncture After Normal NCHCT in Suspected Subarachnoid Hemorrhage

Filed Under: Tags: , , , , February 4th, 2016 Leave a Comment

Acute headache is a common emergency department presentation that accounts for 1-2% of all encounters (Goldstein 2006) The differential includes many life-threatening diagnoses, one of which is aneurysmal subarachnoid hemorrhage (SAH). With an estimated overall prevalence of 2% and a 1-month mortality of 40-45%, SAH is a high-risk disease that no emergency physician wants to miss (Linn 1996).
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Supplemental O2 in COPD Exacerbation

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Does supplemental oxygen harm patients with COPD exacerbations? We explore the basis of this dogmatic teaching.
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The ABCS of Reading C-Spine CTs

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This post discusses a structured approach to reading C-spine CT scans in trauma and accompanies Podcast Episode 32.0
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Journal Review

NEXUS Chest Decision Instruments

Filed Under: Tags: , , January 28th, 2016 Leave a Comment

CT use in the evaluation of trauma patients has risen dramatically in recent years. “Pan-scan” (CT scan from head through pelvis) is used routinely in many trauma centers in spite of the American College of Surgeons inclusion of avoidance of routine whole body CT in trauma in it’s Choosing Wisely recommendations. Although prior studies have demonstrated increased identification of traumatic pathology with “pan-scanning” there has not been a concurrent demonstration of decreased morbidity or mortality.
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Hypocalcemia

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Hypocalcemia is infrequently seen in the ED but management should focus on supplementation and searching for the underlying cause
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Journal Review

Idarucizumab for Reversal of Dabigatran

Filed Under: Tags: , , January 21st, 2016 Leave a Comment

Dabigatran Site of Action (www.medscape.com)

The burdens associated with the use of traditional anticoagulants such as subcutaneous heparins and oral vitamin K antagonists (VKAs) have spurred the popularity of non-vitamin K oral anticoagulants (NOACs) for stroke prevention in patients with nonvalvular atrial fibrillation and for the prevention and treatment of venous thromboembolism.
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Proximal Humerus Fracture

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Proximal humerus fractures are a common injury seen in the ED. We review the imaging, complications and management.
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