June 1, 2020

Background: Humeral shaft fractures are commonly seen in the Emergency Department and emergency management is relatively straightforward: assess for other trauma, assess for radial nerve injury, analgesia, sling or functional bracing and follow up with orthopedics. However, there are debates in management specifically around operative vs non-operative management. The non-operative approach has been the standard but, the rate of surgery has markedly risen in the last decade (Schoch 2017). Operative management appears to reduce the risk of nonunion significantly but, comes with other risks including infections and iatrogenic radial nerve injuries. In the absence of high-quality evidence, marked practice variation persists.

November 9, 2017

This year ACEP 2017 took place in Washington D.C. from Oct. 29th – Nov 1st, 2017.   There were lots of amazing speakers and topics as was evidenced by the eruption of everyone’s twitter feeds with the #ACEP17 hashtag.  I was fortunate enough to attend this amazing conference and approached by several attendees if I would put together a list of my favorite pearls from this conference.  I decided to put a top 10 list together, in no particular order.

November 2, 2017

Background: Acute, minor musculoskeletal injuries (i.e. non-fracture or dislocations) are frequently seen in the Emergency Department. Aside from ruling out a more severe injury, management often focuses on pain relief or mitigation of pain. Though many analgesic agents exist, acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for this indication. Both have important side effects or potential for adverse events that must be considered when prescribing them. Finally, it is unclear if combining the two classes of medications is beneficial.

December 7, 2015

Background: Acute, non-traumatic low back pain (LBP) is a common chief complaint and has been estimated to lead to more than 2.7 million ED visits annually nationwide. It affects a broad range of individuals and can be painful and debilitating long after an initial ED visit. Often times in clinical practice, evidence based decisions on medical management of acute lower back pain seem to be thrown out the window; rather medications are prescribed on a gestalt medicament do jour. NSAIDs, muscle relaxants, and opioids have all been used in isolation and in combination for treating acute LBP but trials investigating the efficacy of these medications combined have produced heterogeneous results.

REBEL Review 52: Classification of Open Fractures

Created February 18, 2014 | Orthopedics | DOWNLOAD

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