Acute Scrotum-Its not always what you think

Whether we are succeptable to them or not, knowledge of the acute scrotum is an essential facet of both paediatric and adult emergency medicine.

An sound approach to both traumatic and atraumatic testicular pathology is needed and this week, Will and Kay will lead us by the hand through these sometimes difficult diagnostic dilemmas.

Here are some excellent scrotal summaries:

Scrotal problems fact sheet 

Fundamentals of exam and core DDx

 

Paediatric Testicular Emergencies

Review journal article of acute scrotum management in children and adolescents

 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392007/ 

Practice guideline acute scrotal pain and swelling

http://www.rch.org.au/clinicalguide/guideline_index/Acute_Scrotal_Pain_or_Swelling/ 

Here are some excellent podcasts with urologists discussing core emergency medicine and acute presentations (caution: the word 'balls' is used willy-nilly)

http://www.pemed.org/blog/2012/9/5/urological-complaints-part-1-the-painful-scrotum.html 

http://www.pemed.org/blog/2012/10/15/urology-part-2-the-painless-scroti.html 

 

Orthopaedic Pearls

Here's an excellent case from the guys at LITFL to introduce the tricky diagnostic conundrum of...

Compartment Syndrome

A Case of Muscular Claustrophobia

And some more pearls and pitfalls on how to deal with this difficult condition.

Compartment Syndrome....Pearls and Pitfalls

Joint Aspiration

1.Knee Aspiration

Here is a basic approach to knee joint aspiration

2. Ankle Aspiration

Less common, slightly trickier and slightly lower on the leg than the knee...is the ankle.

Want to use ultrasound? Do you? Well you can...

#DeathIsAWanker

Here is the amazing talk from SMACC Chicago given by the late Dr John Hinds the Irish Critical Care and Pre-Hospital Physician.

Very inspiring stuff...

Ride On by Michelle Johnston

Paediatric Head Injuries

So here's the deal....

You guys read these articles...have a think about some of the difficulties around paediatric head injuries and how to investigate them...and we will bang this session out in 10 mins...leave early and all go and watch the cricket somewhere.

(...and I will pass on the secret consultant decision rule for deciding who to CT scan...)

Sweet.

Comparison of Head injury Clinical Rules

Here is a nice MD Calc summary of the PECARN rule

http://www.mdcalc.com/pecarn-pediatric-head-injury-trauma-algorithm/#how-to-use

...and is isolated vomiting after a head injury a thing?

"Association of Traumatic Brain Injuries With Vomiting in Children With Blunt Head Trauma"

The Airway Course

Excellent knowledge and skills shown last tuesday at the first of our 2 airway skills sessions. 

Thanks again to Andy and all the course facilitators for their input.

Next week will see you apply these skills to some clinical scenarios so if you feel there are some airway areas that are still a bit unclear...take this week to review Andy's course material...talk to your local frindly SMO on the floor...ask questions...and own the airway!!!

See you next tuesday! 

Here's a link to the course material

PEA Arrest

Cardiac arrests associated with pulseless electrical activity...have traditionally been perceived as having very poor outcomes.

However a number of reversible causes can quickly be identified by the skilled Emergency Physician and, when combined with immaculate basic CPR can facilitate improved morbidity and mortality.

Have a read through the following articles and then consider the algorithm discussed in the papers below which utilises ECG evaluation combined with bedside US.

A potential game-changer....

INTRODUCTORY

NZRC- ACLS for Adults- 2010

INTERMEDIATE

PEA Podcast

(If you can’t cope with the banter…there’s a nice written summary)

ADVANCED

Ruling the Resus Room

Bradycardias

Click on the links below for pre-reading:

INTRODUCTORY

NZRC Guidelines

See one…do one…

INTERMEDIATE

Deal- Evaluation and Management of Bradydysrhythmias- EM Parct 2013

ADVANCED

Bradycardia- Management in the emergency department