Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Nov 2010
ReviewManagement and treatment of elbow and forearm injuries.
Orthopedic injuries to the upper extremity are frequently seen in the emergency department (ED). The emergency medicine practitioner must be proficient in recognizing these injuries and their associated complications, and be able to provide appropriate orthopedic management. This article highlights the most frequent forearm and elbow injuries seen in the ED.
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The practice of wound care has greatly improved and evolved over the years. The emergency provider (EP) can choose from a wide variety of sutures, adhesives, strips, and surgical staples, and uses proven wound closure techniques to address this common Emergency Department (ED) patient complaint. ⋯ EPs should follow a standard examination and ensure that there is no damage to underlying structures (ie, nerves, tendons, and vasculature), and that foreign bodies are meticulously looked for and removed if found. Discharge instructions that alert the patient on warning signs of infection, and having all patients return within 48hours for a wound check are 2 ways to optimize patients' outcomes.
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Emerg. Med. Clin. North Am. · Nov 2010
ReviewEmergent evaluation of injuries to the shoulder, clavicle, and humerus.
This article provides a review of the evaluation and treatment of common injuries to the shoulder, humerus, and clavicle in the emergency department (ED) setting. In addition to a focused review of the shoulder's physical examination, topics include common emergent injuries such as glenohumeral dislocations, proximal humerus fractures, and acromioclavicular separations as well as less common, but important injuries including pectoralis and biceps tendon injuries and sternoclavicular dislocations. Accurate recognition and management of these injuries is essential in the optimal care of patients in the ED.
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Emerg. Med. Clin. North Am. · Nov 2010
ReviewRisk management and avoiding legal pitfalls in the emergency treatment of high-risk orthopedic injuries.
Avoiding legal pitfalls of orthopedic injuries in the emergency department (ED) requires an understanding of certain high-risk injuries, their presentation, evaluation, and disposition. Various pitfalls pertaining to both upper and lower extremity injuries are discussed in detail, with recommendations regarding the history, physical examination, and radiographic techniques that minimize the risk inherent in these injuries. When approaching these injuries in the ED, a high level of suspicion coupled with appropriate evaluation and management will allow the practitioner to avoid mismanagement of these potential pitfall cases.
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The knee plays a significant role in ambulation and the activities of daily living. During the course of these activities and its role in weight bearing, the knee is susceptible to a variety of different forces and the emergency physician should be familiar with the diagnosis and treatment of the injuries that result. In addition to following basic trauma protocols, thorough neurovascular and musculoskeletal examinations should be performed and supplemented with appropriate imaging. Emergency physicians should also consider recent developments in knee anatomy and function when evaluating the patient with an acutely injured knee.