Foundations of Emergency Medicine

Foundations of Emergency Medicine offers a series of courses that are openly shared with residency programs around the country. #FoEMPearls #GrowRoots #FoEM

[Foundations of Emergency Medicine @FoundationsEM]

Get ready EM world! We have a new, weekly series starting THIS MONDAY on Instagram (@foundationsem) fit for anyone looking for a sprinkle of learning on their daily insta scroll. First up: dental trauma! See you Monday 👀

[Foundations of Emergency Medicine @FoundationsEM]

Check this out! Make sure you talk to your didactics team about getting your program signed up for FoEM this academic year! #FoEM #GrowRoots

[Foundations of Emergency Medicine @FoundationsEM]

Are you a resident who desires to have a positive impact on your peers? Join the FoEM Junior Leadership team today! #foem #growroots

[Foundations of Emergency Medicine @FoundationsEM]

Are you interested in contributing to the education of future Emergency Medicine practitioners across the globe? Check out these leadership opportunities! #FoEM #growroots

[Foundations of Emergency Medicine @FoundationsEM]

Appropriate imaging to evaluate for sternal fracture?

A: Must include lateral CXR (consider CT if high suspicion and XR neg)

#FoEMPearls #GrowRoots #FoEM #EmergencyMedicine

[Foundations of Emergency Medicine @FoundationsEM]

Dx and Tx of Flail Chest?

A: >3 adjacent rib fractures with paradoxical motion during respirations
- associated with pulmonary contusion
- Tx with intubation, do chest tube prn

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[Foundations of Emergency Medicine @FoundationsEM]

Tx of Traumatic Aortic Dissection

A: if stable get XR (1/3 normal, mediastinal widening, obscured aortic knob, loss of AP window, R displaced NGT, L displaced bronchus, wide paratracheal stripe, L apical pleural cap)
- if VERY stable get CTA
- OR on beta blocker for BP control

[Foundations of Emergency Medicine @FoundationsEM]

Dx of Traumatic Aortic Dissection?

A: (most die in field) high speed deceleration, chest pain/back pain, new murmur, pulse deficits BUT exam often unremarkable

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[Foundations of Emergency Medicine @FoundationsEM]

Dx and Tx of Nasal Septal Hematomas?

A: dark red hematoma associated with nasal fx/trauma
- must incise and pack to prevent saddle nose deformity/pressure necrosis

#FoEMPearls #GrowRoots #FoEM #EmergencyMedicine

[Foundations of Emergency Medicine @FoundationsEM]

Dx and Tx of Orbital Fractures?

A: diplopia, proptosis, limited EOM, decreased VA
- get CT, consult ophtho/ENT
- check for infraorbital paresthesia or globe injury
- give abx if sinus involvement

#FoEMPearls #GrowRoots #FoEM #EmergencyMedicine

[Foundations of Emergency Medicine @FoundationsEM]

What are some injuries CT scans can commonly miss?

A: diaphragmatic injury, pancreas injury, basilar skull fracture, hollow viscus injuries

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[Foundations of Emergency Medicine @FoundationsEM]

What are the vital sign changes with brain herniation?

A: Cushing's reflex (2/2 increased ICP): Hypertension, Bradycardia, Irregular Respirations

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[Foundations of Emergency Medicine @FoundationsEM]

Treatment of seizures related to eclampsia?

A: Magnesium 6gm IV

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[Foundations of Emergency Medicine @FoundationsEM]

What medications are most appropriate for the treatment of Status Epilepticus?

A: Benzodiazepines, phenytoin vs fosphenytoin (second line), phenobarbital (third line)

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[Foundations of Emergency Medicine @FoundationsEM]

What is appropriate chemoprophylaxis for a healthcare worker exposed to N. meningitidis?

A: Rifampin 600mg BID x2d OR Ceftriaxone 250 mg IM x1 OR Ciprofloxacin 500 mg PO x1

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[Foundations of Emergency Medicine @FoundationsEM]

Prophylaxis for close contacts of a patient with Neisseria Meningitis?

A: Rifampin

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[Foundations of Emergency Medicine @FoundationsEM]

Treatment for Brain Abscess

A: IV ceftriaxone, Flagyl (for anaerobes), and neurosurgery consult

#FoEMPearls #GrowRoots #FoEM #EmergencyMedicine

[Foundations of Emergency Medicine @FoundationsEM]

Describe the technique for Kernig and Brudzinski signs for meningeal irritation:

Kernig: knees hips flexed, extend leg causing pain

Brudzinski: flexion of the neck causes reflexive flexion at hips and knees

#FoEMPearls #GrowRoots #FoEM #EmergencyMedicine

[Foundations of Emergency Medicine @FoundationsEM]

What is the most common cause of meningitis in an adult?

A: Strep pneumo

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[Foundations of Emergency Medicine @FoundationsEM]

Patient presents with diplopia with lateral gaze:

A: Intranuclear ophthalmoplegia
- associated with MS

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[Foundations of Emergency Medicine @FoundationsEM]

What is the dosing for tPA in ischemic stroke?

A: 0.9 mg/kg (up to 90 mg) with 10% of the dose given as a bolus and the rest of the dose given as an infusion over 1 hour

#FoEMPearls #GrowRoots #FoEM #EmergencyMedicine