Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · May 2015
ReviewOrthopedic Emergencies: A Practical Emergency Department Classification (US-VAGON) in Pelvic Fractures.
Trauma is one of the leading causes of death before the age of 40 years and approximately 5% of patients with trauma who require hospital admission have pelvic fractures. This article updates the emergency department classification of pelvic fractures first described in 2000. This information is of practical value to emergency physicians in identifying the potential vascular, genitourinary, gastrointestinal, orthopedic, and neurologic complications and further assists them in the initial evaluation and treatment of patients with pelvic fractures.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEmergency Department Evaluation and Treatment of the Shoulder and Humerus.
Shoulder injuries are among the most common musculoskeletal complaints seen in US emergency departments (EDs). ED evaluation of the shoulder must account for the broad range of potential fracture patterns seen in the clavicle, scapula, and humerus. ⋯ Dislocation of the shoulder is frequently seen, and the ED physician must be skilled in several reduction techniques to optimize a successful reduction. An understanding of when orthopedic consultation is appropriate and when patients can be dispositioned with timely follow-up are integral to complete patient recovery.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEmergency Department Evaluation and Treatment of Pediatric Orthopedic Injuries.
Orthopedic injuries in children are unique when compared to those of adults because of the physiologic differences, especially the growth plates, stronger periosteum, and dynamic state of growth. The approach to the orthopedically injured child requires a gentle yet thorough focus with consideration of the growth plates as a primary area of weakness and growth when the child sustains an injury. Understanding the developmental stages of bones is paramount to being able to manage any injuries. Finally, what appears to be a benign injury may portend more serious issues, because nonaccidental trauma must always be considered in the evaluation of the injured child.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEmergency Department Evaluation and Treatment of Wrist Injuries.
Correct diagnosis of wrist injuries is critical in preventing prolonged pain and dysfunction. Radiographs cannot diagnose a large percentage of injuries. ⋯ Knowledge of the anatomy, normal physical examination findings, and physical examination abnormalities associated with different pathological conditions, is paramount in making the correct diagnosis. This article focuses on the anatomy, diagnosis, and ED management of acute wrist injuries, including fractures and dislocations.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEmergency Department Evaluation and Treatment of Cervical Spine Injuries.
Most spinal cord injuries involve the cervical spine, highlighting the importance of recognition and proper management by emergency physicians. Initial cervical spine injury management should follow the ABCDE (airway, breathing, circulation, disability, exposure) procedure detailed by Advanced Trauma Life Support. ⋯ Computed tomography scans are the preferred initial imaging modality. Consider administering intravenous methylprednisolone after discussion with the neurosurgical consultant in patients who present with spinal cord injuries within 8 hours.