Tactical Medicine News Blog

In Part 1 of this Episode on Pediatric Abdominal Pain, Dr. Anna Jarvis, "the mother of pediatric emergency medicine" & Dr. Stephen Freedman, one of the world's pre-eminent pediatric EM researchers, discuss the nuances of the history, physical and work up of Pediatric Abdominal Pain & Appendicitis and key pearls on how to distinguish serious surgical causes from the very common diagnosis of gastroenteritis. An in-depth discussion on the pearls of the history, physical exam, lab tests, imaging including serial ultrasounds vs CT abdomen, clinical decision rules such as the Alvarado Score, best analgesics and antibiotics in pediatric appendicitis follows. The post Episode 19 Part 1: Pediatric Abdominal Pain and Appendicitis appeared first on Emergency Medicine Cases.

Scalp lacerations are one of the most common injuries which present to the Emergency Department. Applying a dry bandage over the staples or sutures can be a challenge because the tape just has nothing to adhere to. We reviewed the use of tubular cotton gauze to create a beanie hat, but what should you do if you can’t find any tubular gauze? Ever since I wrote about the beanie hat trick, people in the ED have been using the tubular gauze more and we’re always out of stock whenever I look for it!

What is your diagnostic approach to the acutely vertiginous patient? The bottom-line question is: Is the cause peripheral or central in etiology? In this great 2011 systematic review article in CMAJ on Acute Vestibular Syndrome (AVS), the authors review how (un)predictive elements of the history and physical exam are. By definition of AVS, symptoms must be continuous for at least 24 hours and have no focal neurologic deficits.

Patients can become extremely diaphoretic with high fevers or if under the influence of PCP or a stimulant. Slippery, sweaty skin can pose a problem when securing peripheral IV’s. Adhesive tapes that are typically designed for securing these IV’s often slip off… immediately followed by the IV falling out. How can you secure the IV … without using staples and sutures? 

Have you noticed that on “Who Wants To Be A Millionaire”, asking the audience as a lifeline almost always results in the right answer (over 90% of the time)? Dr. David Thorisson (Lund University, Scandinavia) recently approached me with a novel idea of doing the same for Emergency Medicine questions. These questions are currently posted to a public Google Docs document, which allows anyone to post and answer questions.