Category: Orthopedics
Keywords: Salter Harris, Fracture, Strain, pediatric (PubMed Search)
Posted: 10/13/2007 by Michael Bond, MD
(Updated: 2/18/2025)
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Pediatric Strain versus Fracture
Review of Salter Harris Fractures
Please click here for a pictorial of Salter Harris Fractures from FP Notebook.
Category: Pediatrics
Keywords: Foreign Body, Button Battery, Heliox, Respiratory Distress (PubMed Search)
Posted: 10/12/2007 by Sean Fox, MD
(Updated: 2/18/2025)
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Foreign Bodies
• No object should be left in the esophagus for >24 hrs
• Unusual FB’s:
==> Very Sharp or pointed objects may perforate the GI tract and should be removed endoscopically.
==> Long objects (>6cm) or wide (>2cm) objects may not pass and should be remove endoscopically.
• Button Batteries
==> 9% of cases involve more than one battery (x-ray mouth to anus)
==> Hazards:
(1) Heavy metal leakage (Mercury) – low risk but real
(2) Electrical Discharge (Local tissue injury)
(3) Pressure Necrosis
(4) Leakage of Corrosives
==> 85% Pass without symptoms
(1) No intervention if pass the esophagus and pt is without symptoms
• Consider Heliox as a temporizing measure in children with respiratory distress, while awaiting endoscopy/bronchoscopy.
Category: Toxicology
Keywords: valproic acid, poisoning, carnitine (PubMed Search)
Posted: 10/11/2007 by Fermin Barrueto
(Updated: 2/18/2025)
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Valproic Acid (Depakote) - Increased use for both seizure disorder, migraine prophylaxis and bipolar disorder - Causes hyperammonemia with or without hepatic insufficiency (Liver enzymes could be normal!) - Hyperammonemia can occur at therapeutic concentrations and overdose - If the patient is sedated and has hyperammonemia, consider carnitine therapy antidotal - Carnitine IV or PO: 50-100 mg/kg bolus or divided bid, safe to give
Category: Neurology
Keywords: SAH, subarachnoid hemorrhage, aneurysm (PubMed Search)
Posted: 10/10/2007 by Aisha Liferidge, MD
(Updated: 2/18/2025)
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Category: Critical Care
Keywords: abdominal compartment syndrome, decompressive laparotomy, bladder pressure (PubMed Search)
Posted: 10/8/2007 by Mike Winters, MBA, MD
(Updated: 2/18/2025)
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[RESENT - STILL FIXING CODE - THESE TEST EMAILS SHOULD CEASE SHORTLY... SORRY FOR THE INCONVENIENCE]
Category: Vascular
Keywords: Aorta, Enteric, Fistula (PubMed Search)
Posted: 10/8/2007 by Rob Rogers, MD
(Updated: 2/18/2025)
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Suspect an aortoenteric fistula in patients who present with an upper GI bleed if they have ever had a AAA repair. This occurs when a fistula forms between the abdominal aorta and the GI tract (most commonly the duodenum). Patients may present stable or may present critically-ill. Unstable patients with an upper GI bleed and a history of AAA repair should proceed to the OR for laparotomy.
Stable patient may undergo CT scanning and/or endoscopy. Bottom line: If a patient with a history of AAA repair presents with an upper GI bleed, rally your troops (GI, Surgery, etc) ASAP and don't mess around. If you are wrong, and the patient doesn't have a fistula, no big deal. If you are wrong, and the patient does have a fistula, the patient may very well die on you as you struggle to get a regular ICU bed.
Category: Cardiology
Keywords: acute myocardial infarction, reperfusion, ami (PubMed Search)
Posted: 10/7/2007 by Amal Mattu, MD
(Updated: 2/18/2025)
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In the treatment of an acute ST-elevation MI, there are three major signs of successful reperfusion:
Persistent pain/symptoms OR absence of STE resolution by 90 minutes warrants strong consideration of rescue angioplasty.
Category: Orthopedics
Keywords: Back Pain, Guideline, Treatment (PubMed Search)
Posted: 10/7/2007 by Michael Bond, MD
(Updated: 2/18/2025)
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Low Back is one of the most common complaints that we see in the Emergency Department. Our first priority is to rule out those causes that can lead to paralysis or death (i.e.: epidural abscess, pathological fracture, cauda equina syndrome, etc…). However, most of the back pain that we will see is musculoskeletal in origin.
Links to the Clinical Guidelines are listed below:
Category: Pediatrics
Keywords: Concussion, Second Impact Syndrome, Sports Medicine (PubMed Search)
Posted: 10/5/2007 by Sean Fox, MD
(Updated: 2/18/2025)
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Concussions
Colorado Medical Society School and Sports Medicine Committee. Guidelines for the management of concussion in sports. Colo Med 1990;87:4.
Category: Misc
Keywords: administrative, notice, admin, tech (PubMed Search)
Posted: 10/4/2007 by Dan Lemkin, MS, MD
(Updated: 2/18/2025)
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Notes to authors
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Category: Toxicology
Keywords: Isopropanol, toxic alcohol, poisoning (PubMed Search)
Posted: 10/4/2007 by Fermin Barrueto
(Updated: 2/18/2025)
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Category: Neurology
Keywords: Horner's, Horner's Syndrome, Infarction (PubMed Search)
Posted: 10/3/2007 by Aisha Liferidge, MD
(Updated: 2/18/2025)
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Category: Critical Care
Keywords: DIC, sepsis, heparin (PubMed Search)
Posted: 10/2/2007 by Mike Winters, MBA, MD
(Updated: 2/18/2025)
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Category: Vascular
Keywords: aneurysm (PubMed Search)
Posted: 10/1/2007 by Rob Rogers, MD
(Updated: 2/18/2025)
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Category: Cardiology
Keywords: Valvular Disorder, Hypertrophic Cardiomyopathy (PubMed Search)
Posted: 9/30/2007 by Amal Mattu, MD
(Updated: 2/18/2025)
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Category: ENT
Keywords: Sinusitis, Antibiotics, Viral, URI (PubMed Search)
Posted: 9/29/2007 by Michael Bond, MD
(Updated: 2/18/2025)
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Category: Pediatrics
Keywords: Growth, Failure to thrive, Weight Gain (PubMed Search)
Posted: 9/28/2007 by Sean Fox, MD
(Updated: 2/18/2025)
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Category: Toxicology
Keywords: ciguatera, poisoning, fish (PubMed Search)
Posted: 9/27/2007 by Fermin Barrueto
(Updated: 2/18/2025)
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Category: Neurology
Keywords: stroke, cardioembolic events, young patients (PubMed Search)
Posted: 9/27/2007 by Aisha Liferidge, MD
(Updated: 2/18/2025)
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Category: Critical Care
Keywords: pulmonary edema, tube thoracostomy (PubMed Search)
Posted: 9/25/2007 by Mike Winters, MBA, MD
(Updated: 2/18/2025)
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