Contributor: Jared Scott, MD Educational Pearls: Commotio cordis is sudden ventricular fibrillation precipitated by direct impact to the chest A national registry, US Commotio Cordis Registry, reports an average of 10-20 cases annually 95% of reported cases occur in males, indicating possible genetic component Average age of patient in registry is 15 Most cases occur during…
Read MoreContributor: Chris Holmes, MD Educational Pearls: Through world history, there have been various interesting approaches to wound care Ancient Egyptians applied honey, lint, and grease which provided antimicrobial, absorptive and moisturizing properties, respectively Ancient Greeks irrigated wounds with clean water and applied wine and vinegar which may have been antimicrobial One of the first synthetic…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: Through world history, there have been various interesting approaches to wound care Ancient Egyptians applied honey, lint, and grease which provided properties of being antimicrobial, absorption and moisturization, respectively Ancient Greeks irrigated wounds with clean water and applied wine and vinegar One of the first synthetic topical antimicrobials was…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: Pediatric patients frequently have vital signs considered abnormal for age at discharge Large multicenter study recently evaluated if pediatric patients discharged with abnormal vital signs have worse outcomes 97,824 pediatric discharges were included in the study 18.1% were discharged with vitals considered abnormal for age No significant difference in…
Read MoreContributor: Travis Barlock, MD Educational Pearls: The causes of pancreatitis can be remembered with the mnemonic: “GET SMASHED” G: Gallstones (Most common cause of pancreatitis overall) E: Ethanol (Alcohol consumption is the most common cause of chronic pancreatitis) T: Trauma S: Steroids M: Malignancy A: Autoimmune S: Scorpion Sting H: Hypertryglyceridemia E: ERCP D: Drugs…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: Septic arthritis of the sternoclavicular joint is uncommon accounting for <1% of septic arthritis cases Immunosuppression and IV drug use increases the risk Can account for up to 17% of septic arthritis cases in patients who use IV drugs Symptoms are typically vague with pain presenting around where the…
Read MoreContributor: Meghan Hurley, MD Educational Pearls: Venomous snakes in the United States include species from the family Elapidae and subfamily Crotalinae In prehospital setting, elevate the bitten extremity and transport to hospital immediately Do not attempt interventions with the bite site Monitor for progression of swelling past any joint line, systemic symptoms or lab abnormalities…
Read MoreContributor: Jared Scott, MD Educational Pearls: Two conventional ways to aid in external jugular vein (EJ) catheter placement are Trendelenburg’s position and Valsalva’s maneuver by patient One study compared ultrasound visualization of cross sections of EJ and common femoral vein at baseline and with patients in Trendelenburg’s position, Valsalva’s maneuver, and while humming The study…
Read MoreContributor: Meghan Hurley, MD Educational Pearls: Syncope is defined as a loss of consciousness with an immediate return to baseline Differential is broad Cardiogenic Structural (aortic stenosis, HOCUM, etc.) Electrical (long QT syndrome, Brugada, etc.) Neurogenic/neurovascular (brain bleed, etc.) Seizure Everything else Hypoglycemia, anemia, and bleeding into the abdominal cavity are some potential causes to…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: Torus (Buckle) fractures are a commonly encountered pediatric fracture pattern Typically presents as wrist pain secondary to a child falling on outstretched hand One edge of the bone “buckles” or bends because children’s bones are softer and more pliable Management Older studies have shown that short term immobilization with…
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