During your Emergency Medicine (EM) rotation, you’ve encountered numerous lacerations and have honed your suturing skills. Following the primary closure of your most recent laceration, your supervising physician has requested that you apply an appropriate dressing and provide wound care instructions, as the nursing staff are preoccupied with attending to other patients. You look at the Wound Product Information Sheet and are surprised by the variety of dressings available in the Emergency Department …
An Approach to Adult Burns in the Emergency Department
Case: You are working as a 3rd year clerk in the ED and your staff has asked you to see Kathy, a 24 year old female caught in a house fire presenting with burns in multiple areas and difficulties breathing. Burn injuries result in the partial or complete destruction of the skin and can affect any of its three layers: the epidermis, dermis, or subcutaneous tissue.1 In this article, we will explore a …
Clinical Question: How do I measure frailty in the Emergency Department?
Mrs. Vivianne Dubois is an 84-year-old female presenting to your Emergency Department with her daughter. She tells you that she is here because she has been feeling weak and has had a fall. You speak to her daughter and find out that in the past year since her husband’s death, Vivienne has been struggling to take care of herself, requiring assistance with bathing and cooking. Recently, she has had several falls, and her …
Clinical Question: Which ultrasound-guided nerve block is best for acute pain management of rib fractures in the ED?
A 72-year-old male presents to the emergency department (ED) with severe chest pain and difficulty breathing after an MVC. Physical examination reveals tenderness and localized swelling over the left lateral chest wall, with X-ray confirming multiple rib fractures. The patient’s vital signs are stable, but he is visibly distressed and struggling to find a comfortable position. What are nerve blocks? Nerve blocks involve administering local anesthetic near specific nerves to block pain signals …
Can diltiazem replace adenosine as part of the initial management of stable supraventricular tachycardia?
A 50-year-old female presents to your ER with a chief complaint of palpitations. A 12-lead ECG shows supraventricular tachycardia at a rate of 165 bpm, and she is put on telemetry. She is clinically stable. You attempt the modified Valsalva maneuver with no effect. You explain that you will have to give her medication to bring her heart rhythm back to normal. She asks if you will give her “that adenosine drug” and …
When do you use X-ray vs CT for pediatric head injuries?
A 3-year-old boy is brought to the ED by his anxious parents following a head injury he sustained while playing in the playground. He was running when he tripped and bumped his head against the metal steps. As you observe him calmly playing on his tablet in the waiting room, his parents are inquiring about the necessity of skull x-rays. You consider the role of such imaging in investigating pediatric head injuries – …