Indications Percutaneous abscess drainage. An abscess is an inflamed collection of pus, the area is usually tender, warm, firm, & fluctuant to palpation. Any abscess, however small, must be drained for complete resolution. Sometimes there is surrounding cellulitis or lymphangitis and, in the more serious case, fever. Possible Complications Risk of bleeding (damage to adjacent blood vessels) Dissemination of infection (sepsis, bone & joints, endocarditis) Injury of local nerves The procedure may not …
CanadiEM Frontline Primer – Suturing and Wound Closure
Indications Wounds are closed or repaired to minimize risk of further bleeding and infection. Suture repair provides support and strength to hold the viable dermal edges together to facilitate appropriate healing. Good suturing techniques provide better approximation of tissues leading to an aesthetically pleasing result and preservation of function. Possible Complications Infection, bleeding, and possible wound dehiscence are the big ones to talk to the patient about. However, a small percentage of patients …
CanadiEM Frontline Primer – Early Pregnancy – First Trimester Bleeding
Can’t Miss Diagnoses First Trimester Bleeding: Miscarriage (formerly known as spontaneous abortion) Ectopic pregnancy Infection Cervical/vaginal lesions Trauma Coagulopathy Points to focus upon Hx: Last Menstrual Cycle Determine if patient has been on fertility treatments, which will elevate their risk of heterotopic pregnancy (a concurrent intrauterine AND ectopic pregnancies) to roughly 1:200 (much more common than normal rates which are closer to 1:10,000). Prenatal care & screening, prenatal vitamins Screen for other first …
CanadiEM Frontline Primer – MSK – Common Fractures
Common Wrist & Forearm Fractures Radius Overview Colles Distal Radius Fracture Barton Distal Radius Fracture Smith Distal Radius Fracture (a.k.a. reverse Colles) Both Bones Overview Galeazzi Fracture+Dislocation Essex Lopresti Fracture+Dislocation Radial Head Fracture Radial Neck Fracture Monteggia (“Nightstick”) Fracture+Dislocation Ulna Ulna Styloid Olecranon Fracture Common Hand Fractures Carpal Bones Scaphoid Fracture Trapezium Fracture Perilunate Fracture+Dislocation Metacarpal Bones Bennet Fracture – Thumb Pseudo-Bennet Fracture+Dislocation – Thumb Rolando Fracture Boxer’s Fracture – 4th and 5th …
CanadiEM Frontline Primer – MSK – Joint Pain
Can’t Miss Diagnoses Septic Arthritis Trauma Also, assess overlying soft tissues for infections which can also be very life-threatening (e.g. Necrotizing Fasciitis). Open Joint Prosthetic Joint Infection MIMICS Gout Rheumatoid arthritis Osteoarthritis Hemarthrosis Dislocations DDx for Monoarticular Arthritis O – OsteoarthritisS – Septic arthritisT – Tumor in nearby bone / TraumaR – Rheumatic & autoimmune diseaseI – Intra-articular pathologyC – Crystal arthropathy (Gout, pseudogout)H – Hemarthrosis More details here! DDx for Prosthetic Joint …
CanadiEM Frontline Primer – Musculoskeletal & Extremity Injuries
Can’t Miss Diagnoses Traumatic Infectious Inflammatory causes Open joint/Open Fracture Compartment Syndrome Also, assess for soft tissue injury and /or infections which can also be very life-threatening (e.g. Necrotizing Fasciitis). CAUTION:Make sure think about abuse, especially with inconsistent stories) – child abuse, domestic violence, or elder abuse. Points to focus upon Generally, the approach to MSK injuries will be ABCs, Look, Feel, Move: Look + feel for swelling, deformity, crepitus, pallor, faint or …