A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
Figure 1. Procedural sedation agents (courtesy of EMRA).
Procedural sedation is a unique skill that is frequently utilized by Emergency Medicine (EM) trained physicians. Depending on the indication and patient’s clinical status, it can be both stressful and time consuming, but ultimately a procedure that must be mastered to facilitate safe and effective care for our patients. Let’s start with the basic steps and setup and finish with some article reviews.
Kathryn McGregor, MD; Taylor Wahrenbrock, MD; Eric Leser, MD
Read MoreWe’ve all been told to x-ray above and below the area in question. How much we do it varies, but we have all done it at one point, and rarely do I find an abnormality that was occult. Here we question when we can do less in a couple of orthopedic-specific issues.
Jose Reyes, MD
Read More
Figure 1. Lateral radiograph of the hand and of the digit.
The Case:
A 15-year-old presented with right index finger pain. He states he was catching a football and it hit the tip of his right index finger and forcibly flexed it causing pain at his DIP joint. He was initially seen in triage and right hand radiographs were obtained and read by the radiology resident as negative (Figure 1). On examination, the patient had tenderness over the dorsal aspect of the DIP joint with weak extension. Based on the exam and suspicion of a fracture seen on the hand radiographs, the patient was sent back to get dedicated radiographs of the involved digit (Figure 2). Soon after, the radiologist called to report an intra-articular Mallet fracture. The patient’s DIP joint was splinted in extension and sent for orthopedic follow-up.
Scott Sherman, MD
Read More