Lower limb (LL) and especially knee injuries are a very common presentation within the ED, but in the acute phase can be difficult to give a definitive diagnosis and an appropriate treatment / referral plan.
Category: Learning
Elbow Crutches
Measuring for and advising patients on the use of elbow crutches is an important skill for ED staff.
Nail Trephination
Bleeding under the nail from blunt trauma can be very painful. Lucky we have the tools on hand to ease some of that pain.
Upper Limb ED Physio Referrals
Upper limb (UL) and especially shoulder injuries are a fairly common presentation within the ED, but in the acute phase can be difficult to give a definitive diagnosis and an appropriate treatment / referral plan.
Quick-Wee method
Have you ever wanted an infant to PU faster?
Gentle suprapubic cutaneous stimulation with gauze soaked in cold fluid (the Quick-Wee method) led to a clinically and statistically significant increase in voiding and successful urine collection within five minutes for infants aged 1-12 months
An ideal job to be given to parents/carers
Anion Gap & Metabolic Acidosis
The anion gap (AG) represents the amount of unmeasured anions in the plasma.
AG =([Na]+[K]) – ([HCO3]+[Cl])
The main contributor to the AG is albumin (decreasing albumin by 1g/l reduces the AG by 0.25) so hypoalbuminaemia can falsely reduce the AG.
Corrected AG = AG + (0.25*(40-[albumin]))
(However, this relies on getting LFT’s back about 1 hour) Read more
Radial Buckle Fractures
Some Radial Buckle #’s in children can be managed with:
- Well fitting splint
- Advice sheet
This decision tree must be followed to identify suitable patients
If you are concerned about Non-Accidental injury – you must escalate your concern.
Paediatric Clavicle Fracture
Clavicle fracture is a common presentation and some patients can be managed at home without fracture clinic follow up.
Inclusion Criteria
- Isolated mid-shaft clavicle fracture
- Parents/Carers comfortable to manage at home
A-a gradient
A-a gradient = Alveolar Oxygen – arterial Oxygen
This is “relatively” simple way of working out if the paO2 on a ABG is normal, and demonstrates V/Q mismatch well. V/Q mismatch is simple terms is either an area of the lung either under ventilated(pneumonia) or under perfused (PE). Read more
Devastating Brain Injury?
Scenario (Not uncommon)
A patient either post arrest or head injury has a CT demonstrating significant brain injury and Leeds says “No”
