How to Confirm Ankle Joint Penetration

Suspicious lacerations should be investigated, even if the X-ray is normal. A step-by-step pictorial guide. It is a busy Friday evening in the emergency department when you get called to the resuscitation bay for a 14-year-old female who was the restrained back seat passenger in a rollover motor vehicle crash. After a quick call to your significant other to ensure that your daughter is safe in bed, you proceed to evaluate this young patient. You are once again amazed by modern safety technology with the minimal amount of head, torso and abdominal trauma on this patient. After a thorough initial inspection you find that the patient has a large laceration to the lateral side of her left ankle, and swelling that suggests either a fracture or a severe sprain or dislocation. You do note that the laceration is directly over the ankle, and make a note that you will need to determine if that is an “open ankle” once you ensure there are no other life threatening emergencies. You order a set of ankle x-rays with the rest of your trauma work up and give the patient a dose of pain medications prior to shipping her off to get imaging. Once the patient return from her x-rays you are relieved to see there’s no fracture, and you wonder if this could simply be a bad sprain with an overlying laceration. Can this laceration just be irrigated and closed in the emergency department, or do you some other service to weigh in? Open ankle fractures are relatively common in trauma ce...
Source: - Category: Emergency Medicine Authors: Tags: Uncategorized Source Type: news

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For the last 12 years, I have kept a binder full of advice from friends and mental health professionals. After every doctor’s visit or coffee date, I would scribble down notes of what they said so that I could access their words when I needed them. Similarly, I kept a self-esteem file, full of positive comments from readers and loving notes from friends to pump me up when I needed reassurance and validation that I was a decent person who ought to stick around. We all need to rely on doctors, psychologists, and friends to guide us. The gems inside my binder and file afforded me great reassurance in times of darkness. ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Inspiration & Hope Mental Health and Wellness Mindfulness Motivation and Inspiration Self-Help Mindfuless-Based Stress Reduction Personal Growth Present Moment Source Type: blogs
Teens are known to have a penchant for impulsivity and instant gratification. Even scientists have studied these habits and come to the conclusion that teen brains are simply wired for risk. But just what kind of at-risk or high-risk behaviors should parents be on the lookout for? To start with, at-risk behaviors are defined as anything that puts adolescents on the path to future negative consequences such as injury, poor health, incarceration and even death. Since most teens rarely think ahead to the consequences of their actions, it’s up to parents to recognize some of these dangerous behaviors and caution the...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Bullying Children and Teens College Parenting Sexuality Substance Abuse Children At Risk Teen Depression Teen Drug Use Source Type: blogs
Quitting substance abuse by myself? Have you ever asked yourself: Do I need to spend money on treatment? Do I really need to spend months away to get better? Can I quit by myself? You might be wondering if you can do it all yourself and quit cold turkey, without having to go to the “extreme” lengths of checking into a treatment center. The answer? Having an experienced team help you on your path to sobriety can be a great benefit in accomplishing long term sober living. Not only is the detoxification process in itself risky, it comes with many side effects and sometimes can be fatal. Having medically train...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Addiction Addiction Recovery Addiction Treatment and Program Resources Alcohol Rehab Information Alcoholism Drug Rehab Information Drug Treatment Substance Abuse clean relapse sober sober living sobriety treatment center Source Type: blogs
 It’s inevitable that we will suffer emotional pain as we go through life. Whether it’s from a death of a loved one, the ending of a relationship, or any number of other issues, sometimes the pain we experience becomes embedded to such a degree that we can’t seem to recover from it. We might dwell on past hurts to the point that it negatively affects our emotional health, preventing us from moving on and growing as we should. In this episode, we examine this kind of emotional baggage and how to break free of the grip it can have on us. Subscribe to Our Show! And Remember to Review Us! ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: General Grief and Loss The Psych Central Show Emotional Pain emotional recovery Gabe Howard Vincent M. Wales Source Type: blogs
I greatly appreciate the study by Parreira et al., a systematic review on risk factors for low back pain (LBP) or sciatica [1]. The authors conducted an umbrella review and the following adverse risk factors were specified: older age, smoking habit, physical stress on spine by vibration and depression. I have a query with this study with special reference to smoking.
Source: The Spine Journal - Category: Orthopaedics Authors: Tags: Letters to the editor Source Type: research
CONCLUSION: A single session of leech therapy is more effective over the short term in lowering the intensity of pain over the short term and in improving physical function and quality of life over the intermediate term (4 weeks and 8 weeks, respectively). The limitations of this trial are the lack of blinding and the small number of patients. Leech therapy appears to be an effective treat- ment for chronic low back pain. PMID: 30636672 [PubMed - in process]
Source: Deutsches Arzteblatt International - Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research
CONCLUSIONS: There is moderate- and low-quality evidence that there may be a small additional reduction in pain up to 72 hours after surgery with epidural analgesia compared with systemic analgesia. Two very small studies showed epidural analgesia with local anaesthetic alone may accelerate the return of gastrointestinal function. The safety of this technique in children undergoing thoraco-lumbar surgery is uncertain due to the very low-quality of the evidence. The study in 'Studies awaiting classification' may alter the conclusions of the review once assessed. PMID: 30650189 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Education with recommended first-line care may not improve pain outcomes in patients with acute low back pain. When comparing patients who received education with those who received professional consultation without information or advice, researchers found patient education was no more effective than placebo at reducing depression or incidence of chronic low back pain...
Source: The Rheumatologist - Category: Rheumatology Authors: Tags: Conditions Back pain Chronic pain low back pain patient education Source Type: research
Source: Neuropsychiatric Disease and Treatment - Category: Psychiatry Tags: Neuropsychiatric Disease and Treatment Source Type: research
When a marriage dissolves, there is legal process that involves steps of grieving the end of the relationship. Signing papers, although painful, acknowledges the end of years together and also signifies freedom to move on to a new life. Broken friendships, however, have no process in place. Oftentimes the ending is muddled, with confusion over what went wrong and whether or not there is any chance of reconciliation. The broken bond can be just as traumatic as a divorce, especially if you have years invested into the relationship. It can be difficult to work through the blurry blend of emotions including regret, sadness, an...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Friends General Grief and Loss Relationships Self-Help Abandonment Betrayal Coping Skills Friendship irreconcilable differences Rejection Vulnerability Source Type: blogs
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