Emergency medicine clinics of North America
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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.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEnterovirus D68: acute respiratory illness and the 2014 outbreak.
Enteroviruses cause illnesses ranging from benign upper respiratory infections to severe meningitis and encephalitis. A recent uptick in the number of patients, many of them children, with respiratory infections caused by enterovirus 68 (EV-D68) has captured the attention of health care providers and public health administrators. In the United States, this type of infection was confirmed in 1152 people during 2014. This article examines recent trends in EV-D68 infections, reviewing past outbreaks and the 2014 outbreak, and describes the increasing cases of acute flaccid myelitis and their possible connection with EV-D68.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEvaluation and Management of Traumatic Knee Injuries in the Emergency Department.
Posttraumatic knee pain is a common presentation in the emergency department (ED). The use of clinical decision rules can rule out reliably fractures of the knee and reduce the unnecessary cost and radiation exposure associated with plain radiographs. ⋯ Patients presenting after high-energy mechanisms are at risk for occult fracture and vascular injuries. ED providers must consider these injuries in the proper clinical setting.
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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
ReviewThe Emergent Evaluation and Treatment of Hand Injuries.
The hand is especially prone to traumatic injury. Some sources indicate that injuries to the hand account for somewhere between 10% and 30% of patients treated in emergency care settings. ⋯ Because the mechanism of injury often results in damage to multiple tissue structures, a detailed history and evaluation are vital to properly identifying and managing these injuries. This article provides the emergency physician with tools to identify and manage orthopedic injuries to the hand.