Management of Major Pelvic Trauma

$pelvic trauma fracture$ Pelvic trauma frequently is associated with other injuries from the high force required to break the pelvis. Management is focused on stabilizing the pelvis and stopping the bleeding. Due to other injuries requiring emergent surgical stabilization, pelvic trauma is primarily managed surgically with pre-peritoneal packing and external fixation, followed by angioembolization for continued bleeding. Emergency physicians must quickly resuscitate patients while gathering vital information to direct the correct definitive bleeding control strategy. New endovascular techniques such as REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) may change future emergency department strategies and improve mortality in severe pelvic trauma.
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By Heather Mahoney, MD MA|2017-07-19T21:58:25-07:00Jul 19, 2017|Orthopedic, Trauma|

PV Card: Laceration Repair and Sutures – A cheat sheet guide

Laceration repair and suturing are foundational skills for the Emergency Department. This pocket card serves as a quick reference guide for clinicians, and provides a much-needed update and design upgrade from the 2011 PV card on Sutures. This card covers suture/staple removal times, suture sizes, suture material characteristics, special laceration considerations, and suture techniques.

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By Hyunjoo Lee, MD|2021-10-02T18:58:50-07:00Mar 6, 2017|ALiEM Cards, Orthopedic, Trauma|

PV Card: Elbow Injuries

Elbow injuries are a common presentation to the Emergency Department. This pocket card reviews some the imaging, acute management, and some pearls for the following injuries: elbow dislocation, radial head subluxation, supracondylar fractures (such as the xray on the right), radial head fracture, epicondylitis, condyle fractures, and olecranon fracture. Thanks to Dr. Jonathon Hancock (Doctor’s Hospital orthopedist) for the expert peer review.

PV Card: Elbow Injuries

View other PV Cards.

By Melody Glenn, MD|2021-10-02T19:08:45-07:00Dec 12, 2016|ALiEM Cards, Expert Peer Reviewed (Clinical), Orthopedic|

PV Card: Knee Injuries | Quick Reference Guide

Orthopedic injuries are commonly managed in the emergency department. Often a quick bedside reference card is needed to remind the clinician about the acute management decisions. This is the third of a series of orthopedic quick reference cards written by a team from the 2015-16 ALiEM Chief Resident Incubator. The first two were on ankle and hindfoot fractures and hip injuries. This card set covers knee injuries, specifically patella fractures, patella dislocation, and knee dislocation. These cards were expert reviewed by Dr. Scott Sherman, co-editor of the Emergency Orthopedics textbook (Amazon), and illustrations were created by Dr. Mary Haas.
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By Layla Abubshait, MD|2021-10-19T18:58:50-07:00Nov 21, 2016|ALiEM Cards, Orthopedic|

PV Card: Hip Injuries | Quick Reference Guide

Orthopedic injuries are commonly managed in the emergency department. Often a quick bedside reference card is needed to remind the clinician about the acute management decisions. This is the second of a series of orthopedic quick reference cards written by a team from the 2015-16 ALiEM Chief Resident Incubator. The first was on ankle and hindfoot fractures, and this card set covers hip injuries, such as hip dislocations and femur fractures. These cards were expert reviewed by Dr. Scott Sherman, co-editor of the Emergency Orthopedics textbook (Amazon), and illustrations were created by Dr. Mary Haas.

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By Layla Abubshait, MD|2021-10-04T09:29:28-07:00Nov 14, 2016|ALiEM Cards, Orthopedic|

Trick of the Trade: Simple finger traps using gauze roll

Closed reduction of fractures or dislocations in the hand and wrist can be difficulty to achieve. Gravity can serve as an assistant. Commercial finger traps are available, but can sometimes be hard to find in the Emergency Department. An earlier trick of the trade describes the use of a gauze role to build your own finger trap setup. The following describes a simpler way to build finger traps using a gauze roll.

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By Juan Carlos Montoy, MD PhD|2016-10-26T17:04:16-07:00Sep 1, 2016|Orthopedic, Tricks of the Trade|

Figure 1. Laceration overlying proximal interphalangeal (PIP) joint of right second digit. (Photograph by Daniel Ting and Jared Baylis)

A 34-year-old cabinet maker presents to your Emergency Department after accidentally getting his finger caught in a drawer. On examination, he has a superficial, clean laceration over the dorsal surface of the right second digit (Figure 1).

In a previous post, we discussed the approach to identifying, treating, and managing extensor tendon injuries of the hand. In it, we advocate for a high index of suspicion for extensor tendon injuries whenever a patient suffers a laceration to the dorsal aspect of the hand. However, lacerations over the PIP joint deserve special mention. In this article, we focus on the diagnosis of a specific type of extensor tendon laceration: the central slip injury.

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By Daniel Ting, MD|2017-03-11T00:19:16-08:00Jul 25, 2016|CME, Expert Peer Reviewed (Clinical), Orthopedic|