EM Reflections – May 2016

Presented by Dr Paul Page

Edited by Dr David Lewis

 

Top Tips this month:


Trauma

Reminder to use the NB Trauma – Transfer Protocols

Lower GI Bleed in the Elderly

Because of the broad differential diagnosis for hematochezia, taking a careful medical and surgical history is mandatory to guide the subsequent evaluation. Based on its favorable safety profile, as well as diagnostic and therapeutic capabilities, colonoscopy is the preferred modality for managing patients with severe hematochezia and suspected colonic hemorrhage. Urgent colonoscopy has been reported to increase the diagnostic yield and treatment of bleeding stigmata, as well as reduce the rebleeding rate. While most cases of colonic bleeding can be diagnosed endoscopically and treated appropriately, physicians should be able to recognize the situations when alternatives such as radionuclide imaging, angiographic, or surgical management are indicated.

Colles Fracture

CAST vs Slab
Some debate as to whether a full cast or backslab splint is required after MUA of displaced Colles fracture.
Link to – A practical guide to the application of backslabs, splints, CAM boots and Darco shoes for your paediatric and adult patients.The videos are designed to show you how to do each backslab when required, indications are listed but those that are not are usually discussed with orthopaedics (protocols may vary at different sites). In addition you can follow the links at the bottom for additional tips and videos.
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