Emergency Abdominopelvic Injuries.

The presentation of traumatic abdominopelvic injuries in sport can range from initially benign appearing to hemorrhagic shock. A high clinical suspicion for injury, knowledge of the red flags for emergent further evaluation, and familiarity with the initial stabilization procedures are necessary for sideline medical providers. The most important traumatic abdominopelvic topics are covered in this article.

Training and Practice Settings of Physicians Dual-Certified in Emergency and Sports Medicine.

Survey study of training and practice paradigms and job satisfaction of dual-boarded emergency medicine (EM) and sports medicine (SM) physicians. The REDCap survey was sent to 193 American Board of EM members who hold a Certificate of Added Qualification in SM. A total of 124 EM/SM physicians responded (67.

Consider Going Decaf: An Intentional Caffeine Overdose in the Emergency Department.

Background: Caffeine (1,3,7-trimethylxanthine) is a naturally occurring compound found in plants and is the most utilized drug in the world. An estimated 89% of U.S.

Break up the band: Laparoscopic Adjustable Gastric Banding-associated Discitis and Osteomyelitis.

Obesity is an epidemic that adversely affects millions of Americans. In 2017, the Center for Disease Control and Prevention reported that 93.3 million Americans suffer from obesity.

Concurrent Proximal Fractures Are Rare in Distal Forearm Fractures: A National Cross-sectional Study.

Introduction: Distal forearm fractures (DFF) account for 1.5% of emergency department (ED) visits in the United States. Clinicians frequently obtain imaging above/below the location of injury to rule out additional injuries.

Gluteal Burns from a Car Seat Heater in a Neurologically Intact Patient: A Case Report.

Background: Car seat heaters are an increasingly common amenity in vehicles in the United States, but they have been shown to place neurologically impaired patients at risk for significant burns.

Case Report: We discuss the case of a neurologically intact and otherwise healthy 49-year-old man who presented to the Emergency Department with second-degree gluteal and posterior upper thigh burns after using a car seat warmer for 8 consecutive hours. At no point during the course of his drive did he experience discomfort beyond feeling slightly warm.

The Diagnosis and Management of Facial Bone Fractures.

Appropriate medical care for a patient with a facial fracture can not only optimize aesthetic outcomes but also prevent the potential morbidity and mortality of delayed treatment. In this article, we focus on the clinical presentations, physical examination findings, diagnostic imaging, consultations, and follow-up that patients with facial fractures need related to their emergency department management. Specifically, we address the nuances of evaluating frontal, orbital, nasal, maxillofacial, and mandibular fractures.

Don't Just Blame it on the Veins: An Update on Vascular Exertional Limb Pain.

Exertional limb pain is a common problem encountered in recreational and competitive athletes. Affecting both the upper and lower extremities, this broad entity can be musculoskeletal, vascular, neurologic, oncologic, or infectious in origin. This article focuses on the vascular causes of exercise-related extremity pain, which encompass a cadre of elusive diagnoses.

Evaluation and Management of Rotator Cuff Tears: a Primary Care Perspective.

Purpose Of Review: To provide a primary care perspective regarding the evaluation and management of shoulder pain and rotator cuff tears.

Recent Findings: In the primary care setting, rotator cuff pathology is commonly encountered. Information regarding the risks of oral medications for the management of the associated pain keeps mounting.

Longitudinal Improvement in Balance Error Scoring System Scores among NCAA Division-I Football Athletes.

The Balance Error Scoring System (BESS) is a commonly used concussion assessment tool. Recent studies have questioned the stability and reliability of baseline BESS scores. The purpose of this longitudinal prospective cohort study is to examine differences in yearly baseline BESS scores in athletes participating on an NCAA Division-I football team.

Tenosynovial Osteochondromatosis of the Flexor Hallucis Longus in a Division I Tennis Player.

Tenosynovial (extra-articular) chondromatosis (TC) is a condition characterized by the cartilaginous proliferation of synovial cells derived from the synovial lining of bursa and tendon sheaths. These lesions are often multinodular and most commonly present with complaints of swelling or pain. Treatment of TC primarily entails surgical excision.

An evidence-based medicine curriculum implemented in journal club improves resident performance on the Fresno test.

Background: Journal club is a standard component of residency education. Journal club focuses on review and interpretation of the medical literature with varying degrees of evidence-based medicine (EBM) education.

Objectives: To evaluate learning of EBM principles with an EBM curriculum implemented as a component of journal club.

News flash: Old Mother Hubbard reports the cupboard is bare...time for the FDA to let droperidol out of the (black) box.

A quick way for a clinical pharmacist to eliminate himself or herself from "employee of the month" consideration is to mention the term medication shortage. Even with training geared toward maximizing resources, the cumulative disappearance of a plethora of medications for the treatment of nausea, vomiting, and/or primary headaches is almost too much for emergency medicine physicians to manage. With prochlorperazine, metoclopramide, promethazine, and ondansetron in increasingly short supply, it is time for the Food and Drug Administration to revisit droperidol's black box warning driven by QTc interval prolongation, given its questionable validity, and restore droperidol's place in the armamentarium of emergency medicine physicians.

Treating primary headaches in the ED: can droperidol regain its role?

Objective: The aim of this study was to describe the use and efficacy of low-dose (≤2 mg) droperidol for the treatment of primary headaches (ie, migraine, cluster, tension-type headache and trigeminal autonomic cephalalgias, and other primary headaches) in the emergency department (ED).

Methods: A report was generated from a pharmacy database to identify all adult patients who received low-dose droperidol in the ED over a 7-month period; a subsequent retrospective chart review was conducted. Low-dose droperidol was defined as a cumulative dose of ≤2 mg.

Exercise enhances myocardial ischemic tolerance via an opioid receptor-dependent mechanism.

Exercise increases serum opioid levels and improves cardiovascular health. Here we tested the hypothesis that opioids contribute to the acute cardioprotective effects of exercise using a rat model of exercise-induced cardioprotection. For the standard protocol, rats were randomized to 4 days of treadmill training and 1 day of vigorous exercise (day 5), or to a sham exercise control group.