Identifying Fractures or Sutures in Pediatric Trauma Patients
October 13, 2021


Posted by Andy Jagoda MD in: Emergency Medicine , add a comment

Skull sutures normally found in pediatric patients can make it difficult to differentiate a fracture from normal suture lines.⁷,⁹ CT with sagittal and coronal reformatted series as well as 3-dimensional shaded-surface volume-rendered images can accurately differentiate between fractures and sutures.⁹ Fractures have sharp borders and increase in diameter as they approach sutures. Fractures may cross sutures and can be associated with overlying soft-tissue swelling or hematomas and/or widening of the sutures (diastasis).⁹ In comparison, sutures are usually uniform in diameter, have a zigzag pattern with sclerotic borders, and join with (rather than cross) other sutures.⁹ read more

Test Your Knowledge: Acute Ischemic Stroke
August 23, 2021


Posted by Andy Jagoda MD in: Brain Tease , 1 comment so far

Acute ischemic stroke is a leading cause of morbidity and mortality in the United States, and a majority of acute ischemic stroke patients are evaluated for the first time by a clinician in the emergency department. read more

Clinical Pathway for Management of Acute Ischemic Stroke After the 3-Hour Time Window
July 20, 2021


Posted by Andy Jagoda MD in: Clinical Pathways, Feature Update , add a comment

Acute ischemic stroke is a leading cause of morbidity and mortality in the United States, and a majority of acute ischemic stroke patients are evaluated for the first time by a clinician in the emergency department. Our recent issue Acute Ischemic Stroke: Emergency Department Management After the 3-Hour Window presents evidence-based guidelines for the diagnosis and treatment of acute ischemic stroke in patients who present more than 3 hours after their last known well time. read more

Risk Management Pitfalls for Pediatric Patients With Acute Demyelinating Syndromes
June 17, 2021


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Our recent issue Pediatric Acute Demyelinating Syndromes: Identification and Management in the Emergency Department focuses on the most common acute demyelinating disorders in children: Guillain-Barré syndrome and acute transverse myelitis. read more

Test Your Knowledge: Pediatric Acute Demyelinating Syndromes
March 23, 2021


Posted by Andy Jagoda MD in: Brain Tease , add a comment

Acute demyelinating disorders can present with vague complaints and subtle abnormalities of the neurological examination. A thorough history and physical examination are impor- tant for narrowing the differential diagnosis and determining which diagnostic studies are indicated. read more

Test Your Knowledge: Seizures in Neonates
June 29, 2020


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Neonatal seizures are associated with high morbidity and mortality, but they can be difficult to diagnose because they often present with subtle signs and symptoms. Our June issue, Seizures in Neonates: Diagnosis and Management in the Emergency Department, reviews common presentations and causes of neonatal seizures, considerations for emergency department management, and more. read more

What’s Your Diagnosis? Seizures in Neonates: Diagnosis and Management in the Emergency Department
May 29, 2020


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Welcome to this month’s What’s Your Diagnosis Challenge!

Case Presentation: Seizures in Neonates: Diagnosis and Management in the Emergency Department read more

What’s Your Diagnosis? An Evidence-Based Approach to Abnormal Vision
March 25, 2020


Posted by Andy Jagoda, MD in: What's Your Diagnosis , 2 comments

Welcome to this month’s What’s Your Diagnosis Challenge!

Case Presentation: An Evidence-Based Approach to Abnormal Vision

A 40-year-old woman is brought in to the ED by her husband, complaining of blurred vision and dizziness. She said she had visited an urgent care clinic last week with a new diagnosis of migraine headache. Her examination is remarkable for right eyelid ptosis, limited movement of the right eye to left gaze, and a right dilated pupil compared to the left. read more

Risk Management Pitfalls in the Management of Pediatric Patients With Bacterial Meningitis
March 19, 2020


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The presentation of bacterial meningitis can overlap with viral meningitis and other conditions, and emergency clinicians must remain vigilant to avoid delaying treatment for a child with bacterial meningitis. Inflammatory markers, such as procalcitonin, in the serum and cerebrospinal fluid may help distinguish between bacterial meningitis and viral meningitis. Appropriate early antibiotic treatment and management for bacterial meningitis is critical for optimal outcomes. Although debated, corticosteroids should be considered in certain cases. read more

Test Your Knowledge: Evaluation and Management of Life-Threatening Headaches in the ED
February 6, 2020


Posted by Andy Jagoda, MD in: Brain Tease , 1 comment so far

Emergency Medicine Practice Blog Brain Teaser

Though patients often present to the ED seeking relief from headaches that cause significant pain and suffering, 90% of them can be considered ?benign.? It is essential to identify the 10% of headache patients who are in danger of having a life-threatening disorder presenting with a sudden and severe headache to ensure that they are treated quickly and effectively. read more