This is the supine chest/abdominal x-ray of an elderly patient who has presented with abdominal distension with pain and vomiting. Apart from the very obvious (malpositioned nasogastric tube), what interesting radiological sign can you see? Click to enlarge [peekaboo_link name=”Answer”]Answer[/peekaboo_link] [peekaboo_content name=”Answer”] X-ray shows a large amount of free intraperitoneal air under both domes of diaphragm and…
You have just seen a 20 year old patient who presents with dyspnoea and chest pain. He has been partying hard on New Year’s Eve and admits to ‘snorting’ something while at the party. The chest x-ray is as follows; what interesting radiological sign can you see? Click to enlarge [peekaboo_link name=”Answer”]Answer[/peekaboo_link] [peekaboo_content name=”Answer”] There…
It is 1 am. Your resident has just seen a 22 year old man with wrist injury sustained in a MVA and would like your opinion on the wrist x-ray. His plan is to reduce the fracture under sedation and place a below elbow POP slab. Here are the wrist x-rays; would you agree with his plan? Left wrist…
These ankle x-rays are from a 15 year old patient who has injured his left ankle while skateboarding and is unable to weight bear since injury. What can you see? Click to enlarge [peekaboo_link name=”Answer”]Answer[/peekaboo_link] [peekaboo_content name=”Answer”] The AP and the mortise view x-rays show what looks like a Salter and Harris type III fracture…
This episode reviews the article that most people call the PECARN head CT rule or the Kupperman head CT rule (named for the first author). This is an easy to use clinical decision rule that can help us reduce the number of head CTs that we do on children with minor head injury. We owe…
This episode of EM Basic Essential Evidence will review the two articles that led to the adoption of therapeutic hypothermia as a treatment for survivors of cardiac arrest. This is a simple yet highly effective therapy that improves survival and neurological outcome in survivors of cardiac arrest so it is important that we know and…
This is an article published in the last year in the British Medical Journal that looked at the sensitivity of modern CT scanners in detecting subarachnoid hemorrhage. This article made a lot of waves because it suggested that a head CT within 6 hours of headache onset is 100% sensitive for subarachnoid hemorrhage. Some have…
Non-invasive ventilation is a great technique that we can use for just about any patient who is short of breath. We can use it to avoid intubation in our patients who are close to respiratory failure. In this episode, we’ll talk about how non-invasive ventilation works, which patients we can use it on, and how…
This episode will discuss the NEXUS study. NEXUS was a study that studied thousands of patients to validate a set of rules so that we can “clinically clear” patients with possible c-spine injury without getting an x-ray. This study has helped us avoid radiation in certain low-risk patients, saved the cost of x-rays and CT…
All right- let’s keep the laughter to a minimum…today’s episode is talking about how to approach testicular pain in the ED. You need to know how to approach this chief complaint because if you don’t workup the patient correctly, they can lose their future fertility and possibly their testicle. We’ll review how to take a…