Category: Orthopedics

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Orthopedics

Forearm and Wrist Fractures

This summer, in honor of the 7th anniversary of PEMBlog and PEM Currents I will be releasing a mini-season of fracture focused podcasts.

This episode focuses on radius and ulna fractures, including buckle, greenstick, physis and more! learn about the neurovascular assessment of the upper extremity and general management pearls for some of the most common injuries that you will see in the Pediatric Emergency Department.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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Check out PEMBlog for more great educational content, including seven years worth of Fracture Fridays posts

References

Abraham A, Handoll HH, Khan T. Interventions for treating wrist fractures in children. Cochrane Database Syst Rev 2008; :CD004576.

Drendel AL, Gorelick MH, Weisman SJ, et al. A randomized clinical trial of ibuprofen versus acetaminophen with codeine for acute pediatric arm fracture pain. Ann Emerg Med 2009; 54:553.

Douma-den Hamer D, Blanker MH, Edens MA, et al. Ultrasound for Distal Forearm Fracture: A Systematic Review and Diagnostic Meta-Analysis. PLoS One 2016; 11:e0155659.

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Orthopedics

Intranasal Ketamine

I am delighted to bring you this special episode of PEM Currents, the Pediatric Emergency Medicine podcast. It’s all about intranasal ketamine and its use for acute pain management in the Pediatric Emergency Department. I had the pleasure of interviewing Theresa Frey, Assistant Professor from the Division of Emergency Medicine at Cincinnati Children’s. Theresa is the 2016 winner of the Ken Graff Award from the AAP’s Section on Emergency Medicine. Funding from the award supported her study comparing intranasal fentanyl and intranasal ketamine in a randomized controlled trial for the treatment of acute, long bone fracture pain. We talk about the existing evidence, what’s to come in the future and how you can learn more about intranasal ketamine.

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References

Graudins A, Meek R, Egerton-Warburton D, Oakley E, Seith R. The PICHFORK (Pain in Children Fentanyl or Ketamine) Trial: A Randomized Controlled Trial Comparing Intranasal Ketamine and Fentanyl for the Relief of Moderate to Severe Pain in Children With Limb Injuries. Annals of emergency medicine. 2015;65(3):248-254.e241.

Reynolds SL, Bryant KK, Studnek JR, et al. Randomized Controlled Feasibility Trial of Intranasal Ketamine Compared to Intranasal Fentanyl for Analgesia in Children with Suspected Extremity Fractures. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2017.

Yeaman F, Oakley E, Meek R, Graudins A. Sub-dissociative dose intranasal ketamine for limb injury pain in children in the emergency department: a pilot study. Emergency medicine Australasia : EMA. 2013;25(2):161-167.

Podcast: Play in new window | Download (Duration: 23:43 — 32.9MB)

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Orthopedics

Pelvic Avulsion Fractures

Pop goes the apophysis! In teenage athletes the apophyseal cartilage is the weak point along the pelvic rim. Learn about these common injuries in this edition of PEM Currents, the Pediatric Emergency Medicine podcast.

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References

Kocher MS, Tucker R. Pediatric athlete hip disorders. R.Clin Sports Med. 2006 Apr;25(2):241-53, viii.

Pediatric Emergency Medicine Morsels: Pelvic Avulsion Fractures

Podcast: Play in new window | Download (Duration: 5:40 — 8.0MB)

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Orthopedics

Torticollis

Acquired torticollis must be differentiated from more serious symptoms and remains a common presenting complaint in the Pediatric Emergency Department. Learn more about it in this episode of PEMCurrents the Pediatric Emergency Medicine podcast.

Podcast: Play in new window | Download (Duration: 8:10 — 7.6MB)

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Orthopedics

Clavicle Fractures

This edition of PEMCurrents takes a crack at clavicle fractures. The old dictum about broken collarbones states that if both ends of the bone are in the same room it’ll heal fine. For the most part this is true – at least in prepubescent patients. New literature in adults has suggested that outcomes are better for athletes when patients with displaced fractures are repaired in the OR. Ultimately, in the Pediatric Emergency Department our job is diagnose and manage simple fractures appropriately and recognize open fractures and those with neurovascular compromise. We should also be educated about the newest evidence in order to refer patients appropriately to Orthopedics.

Podcast: Play in new window | Download (Duration: 5:48 — 5.5MB)

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Infectious Diseases Orthopedics Podcast

Antibiotic Therapy for Osteomyelitis

Recognizing osteomyelitis can be challenging. Treating it doesn’t have to be – especially in the Pediatric ED. This edition of PEM Currents reviews the current evidence surrounding the initial choice of antibiotic, monitoring treatment response and overall therapeutic duration. 

Podcast: Play in new window | Download (Duration: 10:58 — 15.3MB)

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Orthopedics Podcast

Forearm fractures

Grab your BBFF (or BFF) and FOOSH your way on over to PEM Currents for a discussion surrounding forearm fractures, one of the most common Orthopedic injuries seen in the Pediatric ED.

Podcast: Play in new window | Download (Duration: 7:25 — 3.5MB)

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