About Fred Wu, MHS, PA-C

Lead PA
Department of Emergency Medicine
Kaweah Delta Medical Center (Visalia, CA)

Hot off the press: Clinical practice guideline for ketamine in the ED

Ketamine (475-10)

A 3 year old girl is brought into the ED with an abscess to her groin. Upon examination it is fluctuant and needs incision and drainage. Next door is a 5 year old boy, who fell off his bed and has an angulated radius fracture that needs reduction.

Hhhmmmm…how to manage these patients? Local anesthesia? Hematoma block? Nothing (aka brutacaine)? What about ketamine, that seems popular these days. IV? IM? With or without atropine? So many decisions!

Luckily you were surfing the internet one night and came across the 2011 clinical practice guideline on ketamine in the ED, which was just published.1

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By |2017-02-28T09:43:19-08:00Mar 1, 2011|Pediatrics, Tox & Medications|

Tricks of the Trade: Nursemaid elbow reduction

We’ve all seen it before while working in the ED. A parent brings in their child because they pulled on their arm, and now the child is not using it. Parents are thoroughly convinced that the child’s arm is either broken or dislocated. We all recognize this as radial head subluxation or “nursemaid’s elbow” and immediately attempt to reduce it. The provider takes the injured arm, supinates at the wrist and flexes at the elbow. Does the child scream? What if nothing happens?

Is there an alternative technique to reducing a nursemaid elbow?

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By |2016-11-15T22:02:31-08:00Jan 19, 2011|Orthopedic, Pediatrics, Tricks of the Trade|

EMS officially recognized as an EM subspecialty

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EMS was officially recognized as an EM subspecialty by the American Board of Medical Specialities on September 23, 2010!

Residency programs have already implemented EMS Fellowship Training Programs to provide physicians with specialty training in prehospital care, medical direction, and research in the prehospital arena. The development of this new subspecialty was a collaborative effort between the National Association of EMS Physicians, the American College of Emergency Physicians, the Society of Academic Emergency Medicine, and the American Board of Emergency Medicine. The first certification exam is tentatively scheduled to be administered in 2013. Click here to see the announcement.

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By |2016-11-11T19:00:25-08:00Oct 5, 2010|Medical Education|

Do you belong to a listserv? My favorites

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An email mailing list (or listserv) is a great way to communicate with a large group of people. Once you subscribe to a mailing list, an email sent to a single, common email address will be distributed to everyone who is subscribed to the list. You can find lists for nearly everything and anything!

There are a multitude of lists for various medical specialties. These lists unite people from all over the country (and world) from various practice backgrounds such as academic/community medical centers to rural hospitals/clinics. We are all connected by the power of the internet. The lists are a great way to generate discussion on clinical cases, the newest literature and the experiences of the list’s members.

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By |2016-12-08T10:15:08-08:00Sep 14, 2010|Medical Education|
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