Treating Fingertip Amputations
Fingertip injuries and amputations are common in the emergency department, often occurring on weekends when consultants are not available. Some experienced physicians may consider rongeuring distal tuft amputation injuries, but simple closure and expert consultation for more difficult cases are suggested.A fingertip amputation within zone III involving total amputation of the distal tip, fingernail, matrix, and tuft. Photos by M. Roberts.Care of fingertip amputations in the ED should focus on removing debris and cleaning the wound as best as possible, closing the wound using available skin, bandaging and splinting for c...
Source: The Procedural Pause - December 5, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Figure-of-Eight Sutures for Bleeding Varicose Veins
The figure-of-eight suture is a fascinating technique, often used in unique cases. The stitch is extremely secure and easy to place. It can be used to save time during long, complicated repairs and to create additional strength in high-tension areas. The figure-of-eight stitch can be modified to bring skin edges together or close off small bleeding arteries, varicose veins, or even bleeding hemorrhoids. Multiple figure-of-eight sutures can be used in a row.The idea is to use a single suture to surround a small area of tissue in a box shape to close a laceration or put pressure on a small site. Figure-of-eight sutures ca...
Source: The Procedural Pause - October 1, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Sharing Tension to Repair Chainsaw Injuries
As autumn rolls around, many people are cutting wood for their fireplaces, which can precipitate chainsaw, axe, and saw injuries. These lacerations can be tricky to repair because they often bleed profusely and leave jagged edges. They may also be dirty and harbor foreign bodies such as wood chips, metal, and rust. They may even disrupt underlying tendons, ligaments, and bones. Amputations are uncommon, but do occur.Extremity injuries from chainsaws leave ugly, macerated skin disruptions and lacerations. Even chainsaws that are turned off may cause lacerations and puncture wounds. Most injuries affect the hands and legs...
Source: The Procedural Pause - September 3, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
India: Diphtheria, Pertussis and Tetanus
Although global incidences of Diphtheria, Pertussis and Tetanus declined dramatically during the second half of the twentieth century, relatively high rates for these diseases continue to be reported from India. India accounted for 17.7% of the total World’s population in 2018, but reported 46% of global Tetanus, 53% of global Diphtheria (and only 10.2% of global Pertussis) that year. Similarly, 68% of the population of Southeast Asia (SEA) live in India, while that country accounted for 85% of Diphtheria, 75% of Pertussis and 90% of tetanus for SEA in 2018. [1-4] Trends for these data are charted in the foll...
Source: GIDEON blog - August 16, 2019 Category: Databases & Libraries Authors: Dr. Stephen Berger Tags: Ebooks Epidemiology General Graphs ProMED Source Type: blogs
Diphtheria in Thailand
Although two fatal cases of diphtheria were recently reported in Thailand [1], rates of this disease have declined dramatically since the 1970’s. In fact, Thailand can serve as an icon for the effectiveness of vaccination. In the following graph, I’ve contrasted rates of diphtheria, pertussis and tetanus with WHO estimates of DPT vaccine uptake. The second graph depicts the effect of DPT vaccination on diphtheria mortality in this country. [2,3]
References:
http://www.promedmail.org/post/6453182
Berger S. Infectious Diseases of Thailand, 2019. 506 pages , 169 graphs , 2,339 references. Gideon e-books,...
Source: GIDEON blog - May 3, 2019 Category: Databases & Libraries Authors: Dr. Stephen Berger Tags: Ebooks Epidemiology Graphs ProMED Source Type: blogs
Harmful Choices and Vaccine Refusal
By Dominic Wilkinson @Neonatalethics Last week, medical specialists in the US reported a case of severe tetanus in an unvaccinated 6 year old child, (who I will call ‘C’). The boy had had a minor cut, but six days later he developed intense painful muscle spasms and was rushed to hospital. (Tetanus used to […] (Source: blog.bioethics.net)
Source: blog.bioethics.net - March 14, 2019 Category: Medical Ethics Authors: Dominic Wilkinson Tags: Clinical Ethics Decision making Health Care Children and Families Dominic Wilkinson's Posts syndicated Source Type: blogs
The Essential Checklist for Ankle Dislocations
Immediate relocation of ankle dislocations is necessary to preserve the vascular or neurological integrity of the lower extremity and relieve extreme pain. Literature reviews reveal that early reduction followed by a short period of immobilization (six to 12 weeks) and functional or physical rehabilitation produce good clinical outcomes. (Injury 2017;48[10]:2027).Left ankle dislocation from a football accident. Photo by M. Roberts.Ankle dislocations occur from blunt or traumatic incidents such as sporting events (football, gymnastics), motor vehicle crashes, falling, or jumping. Patients may state that their toes we...
Source: The Procedural Pause - March 1, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Migrant Caravan, Central America, and Vaccination Rates
Many commentators have recentlywritten andsaid that members of the migrant caravan and Central American immigrants in general are diseased. Former Immigration and Customs Enforcement agent David Ward claimed that the migrants are “coming in with diseases such as smallpox,” a disease that the World Health Organization (WHO) certified as beingeradicated in 1980. One hopes Mr. Ward was more careful in enforcing American immigration law than in spreading rumors that migrants are carrying one of the deadliest diseases in human history nearly 40 years after it was eradicated from the human population. But even on oth...
Source: Cato-at-liberty - November 1, 2018 Category: American Health Authors: Alex Nowrasteh Source Type: blogs
Michael Fine's Health Care Revolt
Michael Fine, M.D., HealthCare Revolt: How to Organize, Build a Health Care System, and ResuscitateDemocracy – All at the Same Time (Oakland, CA: PM Press, 2018). Dr. Michael Fine is a man on fire. He ’s on fire with anger about a healthcare marketplace that serves well to maximize the profits of investors and CEOs, but violates the values of many of those working in it. He’s on fire with enthusiasm about the potential of public health and prevention and about the value of integrated primary care. He’s on fire with determination to work to change our scattered health care marketplace into an actual health care syst...
Source: Health Care Renewal - September 3, 2018 Category: Health Management Source Type: blogs
Travel tips: What you need to know before, during, and after you go abroad
Summer may be winding down, but travel isn’t! Getting ready for a big trip abroad can be a lot of work — especially for people with health concerns. This travel tips checklist can pave the way for a smooth journey.
Before your trip
Check for travel advisories
You should be aware of health or political circumstances relevant to your destination(s). The US Department of State has a number of resources for the traveler, including postings on health and security alerts for specific countries.
Check the CDC’s traveler health information
There is a wealth of information here, including general advice for travelers...
Source: Harvard Health Blog - August 27, 2018 Category: Consumer Health News Authors: Wynne Armand, MD Tags: Health Source Type: blogs
Tropical Travel Trouble 011 Tonsillitis and the Bull
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
aka Tropical Travel Trouble 011
Peer Reviewers: Dr Jennifer Ho, ID physician QLD, Australia and Dr Mark Little, ED physician QLD, Australia.
You are working in far North Queensland and encounter a 20 year old Indigenous man with tonsillitis on your ED short stay ward round. He has been receiving IV penicillin and metronidazole overnight but is deteriorating and now cannot open his mouth beyond 1.5cm, and has a swollen neck (some might say ‘Bull neck’). In add...
Source: Life in the Fast Lane - July 25, 2018 Category: Emergency Medicine Authors: Amanda McConnell Tags: Clinical Cases Tropical Medicine antitoxin bull neck c. diphtheriae c.ulcerans DAT pseudomembrane vaccine Source Type: blogs
Tropical Travel Trouble 011 Tonsillitis and the Bull
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
aka Tropical Travel Trouble 011
Peer Reviewers: Dr Jennifer Ho, ID physician QLD, Australia and Dr Mark Little, ED physician QLD, Australia.
You are working in far North Queensland and encounter a 20 year old Indigenous man with tonsillitis on your ED short stay ward round. He has been receiving IV penicillin and metronidazole overnight but is deteriorating and now cannot open his mouth beyond 1.5cm, and has a swollen neck (some might say ‘Bull neck’). In add...
Source: Life in the Fast Lane - July 25, 2018 Category: Emergency Medicine Authors: Amanda McConnell Tags: Clinical Cases Tropical Medicine antitoxin bull neck c. diphtheriae c.ulcerans DAT pseudomembrane vaccine Source Type: blogs
Nailed It!
What do you do for a nail from a nail gun in the hand? This procedure is simple, but you have to worry about the aftermath. Complicated issues may arise post-procedure in the days to weeks after extraction, including retained foreign bodies, infection, fractures, disability, pain, nerve damage, tendon rupture, and cosmetic concerns.Removing the nail is only half the battle. Proper removal, treatment, and follow-up should be considered with all foreign bodies in the skin, especially the hand. Being prepared for the possible aftershocks will help your patient have a successful recovery.A 23-year-old man with a nail fro...
Source: The Procedural Pause - June 1, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Fertility-Regulating Vaccines Being Tested in India
In 2015, after his country was targeted with the fertility-regulating tetanus vaccination containing the hCG hormone, Dr. Wahome Ngare from the Kenyan Catholic Doctors Association drew our attention to a document titled National Security Study Memorandum 200 (NSSM 200) – April 1974. [1] He explained how this one paper had convinced him that the World […]
VacTruth.com (Source: vactruth.com)
Source: vactruth.com - May 30, 2018 Category: Allergy & Immunology Authors: Christina England, BA Hons Tags: Injuries & Deaths Fertility Vaccines India infertility truth about vaccines Source Type: blogs
