The Almighty Hematoma Block for Wrist Fractures

This study found a "statistically significant difference during initial hours after fracture reduction and fixation so that pain intensity was less in elderly patients under hematoma block than patients who underwent general anesthesia in one and six hours after surgery." Most importantly, patients in the hematoma block group required less narcotic pain medication compared with the general surgery population.Experienced providers often know exactly where to inject anesthesia for hematoma blocks. Ultrasound-guided injection techniques, however, prove to be more accurate. Using ultrasound to identify the hematoma and fracture before and during injection will improve technique when landmark localization is difficult. (J Emerg Med 2015;48[3]:310.).​Hematoma blocks also work very well for wrist fractures in children. Not only do hematoma blocks provide adequate pain control, they also increase patient satisfaction and decrease length of stay and need for resources in the emergency department compared with the use of moderate or deep sedation. (J Hand Surg Am 2015;40[1]:57.)Wrist fracture reduced and splinted after using a hematoma block. Photo by Martha Roberts.The ProcedureHematoma block of the wrist for wrist fracture using a lidocaine injection.The ApproachReview radiographs and locate the wrist fracture. Mark the area you plan to inject with a pen.Have the patient supine on the stretcher. Dissuade the patient from watching you complete the setup and injection.Wash ...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

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ConclusionHemiplegic spontaneous cervical EDH occurs very rarely. It is often misdiagnosed as ischemic stroke and is likely to be administered with thrombolytic agents, making the patient's symptoms worse. Early diagnosis and rapid management of cervical EDH increase the likelihood of complete recovery of the patient's symptoms. Therefore, if there are unilateral weakness and neck pain without cranial nerve dysfunction and there is no evidence of stroke in the brain imaging, spinal EDH should be considered.
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
We describe the case of a 37-year-old man with a 20-year history of psoriatic arthritis. The patient presented with abdominal pain, watery diarrhea with mild hematochezia, and a reported 24-pound unintentional weight loss over the past five months. Of note, the patient began treatment with etanercept five months earlier after discontinuation of infliximab for his psoriatic arthritis symptoms. Colonoscopy with terminal ileum intubation revealed active colitis and intestinal biopsy results showed marked ulcerations and non-caseating granulomas, indicative of CD. Etanercept was subsequently discontinued and the patient was st...
Source: Journal of Drugs in Dermatology - Category: Dermatology Tags: J Drugs Dermatol Source Type: research
Authors: Alexis AF, Rendon M, Silverberg JI, Pariser DM, Lockshin B, Griffiths CE, Weisman J, Wollenberg A, Chen Z, Davis JD, Li M, Eckert L, Gadkari A, Shumel B, Rossi AB, Graham NM, Ardeleanu M Abstract Dupilumab, a monoclonal antibody that blocks the shared receptor subunit for interleukin (IL)-4 and IL-13, is currently approved for the treatment of adults with inadequately controlled moderate-to-severe atopic dermatitis (AD). The efficacy and safety of dupilumab for AD among racial subgroups is unknown. This post hoc analysis from three phase 3 trials assessed the efficacy and safety of dupilumab vs placebo by ...
Source: Journal of Drugs in Dermatology - Category: Dermatology Tags: J Drugs Dermatol Source Type: research
Authors: Green LJ, Yamauchi PS, Kircik LH Abstract Psoriasis (PsO) is a common, systemic, chronic inflammatory disease characterized by key clinical symptoms, including itching, pain, and scaling, and is associated with substantial physical, psychosocial, and economic health burdens. Currently, there is no cure for PsO; however, the introduction of biologic therapies has revolutionized the clinical management of patients with PsO by expanding treatment options to include multiple therapies with different mechanisms of action targeting cytokines, including tumor necrosis factor inhibitors (TNFis), interleukin (IL)-1...
Source: Journal of Drugs in Dermatology - Category: Dermatology Tags: J Drugs Dermatol Source Type: research
Publication date: Available online 19 August 2019Source: Trends in Food Science &TechnologyAuthor(s): Qingying Fang, Jielun Hu, Qixing Nie, Shaoping NieAbstractBackgroundAs an important role of host homeostasis, the glycometabolism was closely related to the process and metabolic pathways of carbohydrates such as glycolysis, hexosamine biosynthetic pathway, and pentose phosphate in the host. Disorders of glycometabolism result in a series of metabolic diseases, such as diabetes, obesity, hypoglycemia, and etc.Scope and approachPolysaccharides, which were widely existing in daily diet and cannot be directly digested by ...
Source: Trends in Food Science and Technology - Category: Food Science Source Type: research
Publication date: Available online 20 August 2019Source: LWTAuthor(s): R. Becerril, S. Manso, C. NerínAbstractThe influence of the growth of Aspergillus flavus and Escherichia coli on the concentration of the main compounds released by essential oils of cinnamon, clove and oregano has been studied. A diffusion vapour test and a subsequent analysis of three different areas of the plate were carried out. The results showed that in absence of microorganisms a gradient of concentration from the centre towards the periphery of the plate was observed for eugenol, carvacrol and cinnamaldehyde but not for thymol or linalool...
Source: LWT Food Science and Technology - Category: Food Science Source Type: research
This study provides insight into biodegradable packaging by which synthetic packaging could be substituted.
Source: Food Packaging and Shelf Life - Category: Food Science Source Type: research
Publication date: Available online 17 August 2019Source: Food ControlAuthor(s): Qiang Xia, Hong Tao, Yunfei Li, Daodong Pan, Jinxuan Cao, Lianliang Liu, Xiaowei Zhou, Francisco J. BarbaAbstractWhen ultrasonic stimulation is applied to plant seeds it may promote the development of new adaptive characteristics during germination, thus providing an alternative to regulate nutritional and physicochemical attributes of germinated seeds. However, there is rather limited information concerning high-intensity ultrasound (HIU) effects on the germination process of crop seeds as foodstuff. This investigation aimed at examining the e...
Source: Food Control - Category: Food Science Source Type: research
This study examines the extent to which data linkages between Indian Health Service, tribal data, and cancer registries affect cancer incidence rates among American Indians/Alaska Natives (AI/ANs) in Michigan. The incidence of tobacco- and alcohol-associated cancers for 1995-2012 was analyzed to compare rates of the Upper Peninsula (UP) and Lower Peninsula (LP) in Michigan and among AI/ANs and non-Hispanic Whites (NHWs). Complete linkage resulted in 1,352 additional AI/AN cases; 141 cases were linked via IHS records alone, while 373 were linked via tribal records alone; 838 were linked through both IHS and tribal records. ...
Source: Journal of Health Care for the Poor and Underserved - Category: International Medicine & Public Health Authors: Tags: J Health Care Poor Underserved Source Type: research
CONCLUSIONS: Refugees had comparable burden of non-communicable diseases, but a greaterleast once during the study period proportion of refugees than of the U.S. population had uncontrolled conditions. Duration of follow-up, obesity, tobacco use, gender, age, and region of origin were risk factors for diagnosis. Culturally-tailored chronic disease management strategies are needed. PMID: 31422992 [PubMed - in process]
Source: Journal of Health Care for the Poor and Underserved - Category: International Medicine & Public Health Authors: Tags: J Health Care Poor Underserved Source Type: research
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