Back pain is a common presentation to the Emergency Department. It is associated with disability, health care expenses, and a loss of wages and productivity. When caring for a patient and developing a back pain differential diagnosis, remember to consider age, the history, physical exam findings, laboratory results, and imaging (if needed). Be sure to keep in mind the red flags for back pain that include: history of IV drug use, history of …
Tiny Tip: SCALP for the Layers of the Scalp
At some point during clinical teaching in emergency medicine, someone is likely to ask you about the layers of the scalp, and Rosen’s provides a helpful mnemonic for remembering them1: S – skin C – connective tissue A – aponeurosis L – loose areolar tissue P – periosteum You may be asking yourself why you would need to know about the layers of the scalp. Isn’t this just the sort of trivia you …
Tiny Tips: How ready is this child?
Not many neonates are delivered in the Emergency Department, but those rare babies who greet the world for the first time under the fluorescent lights of the resuscitation bay are precisely those who warrant urgent and concise communication about their clinical status to our obstetric, paediatric, and neonatologist colleagues. The Apgar score is an assessment tool designed for precisely this kind of communication. Developed by Virginia Apgar, an American obstetrical anaesthesiologist, the Apgar score …
Tiny Tips: HEADACHe Red Flags Mnemonic
Patients with complaints of acute headache comprise 4% of emergency department visits.1 Most headaches presenting to the ED are primary headaches such as migraines, however, important secondary causes, such as hemorrhage, cannot be missed.2. A recent CrackCast outlined an excellent approach to headache red flags. The HEADACHe mnemonic can help you remember these red flags3! History describing the worst headache of life or a headache that is different than usual Exertion as a trigger for …
Tiny Tips: Approach to Abnormal Uterine Bleeding
Whether the patient is an expecting mother, a post-menopausal woman, or a young adolescent, abnormal uterine bleeding is distressing for the patient, and often overwhelming for learners. Consider the ‘CAUSES OF bLOOD’ to better tailor your investigations and management. Cancer Abruption Urogenital infections (PID, endometritis, salpingitis) Severe menorrhagia Ectopic pregnancy Spontaneous abortion Ovarian cyst rupture Fibroid (Leiomyoma) b… Location of placenta- placenta previa Ovarian torsion Onset after delivery – Post-Partum Hemorrhage Drugs – …
Tiny Tip: Is this a ‘CASE’ of an elbow fracture?
An elbow fracture is a common pediatric injury in emergency medicine. These fractures present challenges in diagnosis due to the maturing skeletal anatomy and the subtlety of these injuries.1 Plain radiographs are adequate to detect elbow fractures in most cases and a systematic approach can help learners diagnose these pathologies.2,3 An approach to reading elbow radiographs: After confirming patient identification and appropriate radiographic view, a mnemonic to help guide your approach to elbow …