PEM Review 022 – NEW FOAMed // LISFRANC INJURY // TEG // TRAUMA // BRUEs //

foamcross           PAEDIATRICFOAM.COM

Firstly, an unashamed plug for a new project I am excited to be involved with. The London School of Paediatrics is venturing into the FOAMed world, and our new site is launching this month – you can see it here http://www.paediatricfoam.com. Take a look at @jround999’s brilliant ‘Inotropes made simple’ or this post by yours truly on Kawasaki Disease.

lisfranc.jpg   DON’T PUT YOUR FOOT IN IT…

A Lisfranc injury is an injury resulting from fractures of bones of the midfoot, or rupture of ligaments. (Eponym fans – Jacques Lisfranc was an 18th century surgeon who described this injury in soldiers falling from horses trapping their foot in a stirrup, and dislocating the midfoot). On X ray you’ll see a widening in the space between 1st and 2nd metatarsals. The patient must be strict non-weight bearing, and orthopaedics need to see ASAP. @CoreEM are here with a short podcast to explain more.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

teg-report TEG

Major haemorrhage in paeds trauma is not common – so when someone clever asks for a TEG (thromboelastogram) in the middle of a paeds trauma call, the more paediatric orientated amongst us are left blankly staring at a colourful diagram hoping it will miraculously reveal its meaning. Luckily @EMdocsdotnet are here to help with a guide to interpreting the TEG – a point of care test which provides ‘an assessment of near real-time, in-vivo clotting capacity, providing information regarding the dynamics of clot development, stabilization, and dissolution’.

Bonus: Characteristic TEG waveforms (TEG for dummies):

teg

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

top-secret1          FOAMed CONFIDENTIAL

We live our lives online, and increasingly for some doctors, this includes work life – with huge potential learning benefits but also big risks if confidentiality is not respected. @EMdidactic has a piece of essential reading for consumers and creators of FOAMed, dealing with confidentiality and de-identification of patient information.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

brue         TROUBLE BRUE-ING?

Listen to this two-part podcast on Brief Resolved Unexplained Episodes on @pedscases (which are NO LONGER called Acute Life Threatening Events or ALTEs, take note!) then test yourself on your knowledge. Good for anyone new to the paeds ED.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

hernia  TIME IS TESTICLE

Learn how to reduce hernias in babies – it is not OK to ‘wait for a surgeon’ to try, and you will do more harm by waiting than having a go (the swelling increases fast and venous obstruction is a real possibility). Thanks @stemlyns for this first piece in a series of paeds surgery topics.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s