Why do we splint? Splinting is one of the fundamental procedures of the Emergency Department (ED). How well-versed are we with it? Why do we even splint? By the end of this post, you will know the reason why we splint, when to splint, and just as importantly — when NOT to splint in the ED.
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The purpose of the SplintER series is to teach the fundamentals and introduce advanced concepts of splinting to the Emergency Medicine (EM) professional. Humans have been splinting their injuries since 1300 B.C.1 Although the fundamentals have not changed, splint selection and application require some thoughtful consideration. A 2017 prospective, observational study in the Journal of Pediatric Orthopaedics demonstrated that more than 90% of splints applied in the Emergency Department were inappropriate (30% applied by EM attendings), as evaluated by orthopaedic surgeons.2 While that number may not be representative in your institution, it certainly highlights the inadequacies that many of us feel when approaching a splint!
Our work isn’t easy, but it would be impossible without the help of our colleagues. It’s time for our second post on How Our ED Colleagues Stay Healthy in EM!
Liz Crowe is an Advanced Clinical Social Worker from Brisbane, Australia. She is no stranger to the FOAMed world, and her electric personality is infectious. Always laughing, always trying to make others smile, that’s just how she rolls. Here’s how she stays healthy in EM!
Our latest ALiEM Card introduces the “Rule of 2’s,” a simple method that uses eye anatomy to help you recall some of the major ocular diagnoses! It builds a framework for your physical exam and will help you include or eliminate some of the more common ocular conditions.
The Rule of 2’s is easy to remember: 2 eyes, 2 major diagnoses to consider for each ocular layer, as you move anterior to posterior.
A young man is brought into an emergency department after an electric lawn edger cut through his work boot and into the dorsum of his right foot. He has a clearly contaminated 5 cm x 1 cm laceration on the lateral side, and an underlying tendon is exposed. Sensation is diminished around the wound and he is unable to actively extend his 5th toe past a neutral position. How would you diagnose and repair his extensor tendon injury?
Dr. Linda Regan is an emergency physician from Baltimore, Maryland. When she’s not on shift, she can be found taking care of her residents and colleagues, always placing others before herself. Dr. Regan’s holistic approach to her career and everyday life is something for all of us to emulate! When she’s not occupied with one of her many jobs, she can be found enjoying time with family and friends. Here’s how she stays healthy in EM!
If you have spent any time working in an emergency department in the last 10 years, you have undoubtedly come across a conversation about wellness and burnout in medicine. Despite increasing awareness, the data is bleak: Emergency Medicine (EM) physicians experience burnout more than any other specialty.1 As we consider that EM was the second most popular Match in 2017, it’s important to focus on collaborative efforts and ensure that the increasing number of EM trainees does not lead to a generation of burned out EM providers.2