Showing 1-20 of 65 for: Essential Evidence Topics > Trauma and injuries 
- Acetaminophen toxicity
Essential Evidence Topics, 28-Sep-2022
Overall Bottom Line: Address basic life support first, and then obtain an accurate history of quantity, timing, type of ingestion and concomitant ingestions. If within 4 hours of ingestion give activated charcoal. Obtain a stat acetaminophen level and
- Achilles tendon rupture
Essential Evidence Topics, 16-Feb-2021
Overall Bottom Line: A positive Thompson (calf squeeze) test is highly suggestive of achilles tendon rupture in the patient who presents with the acute onset of posterior heel pain and an appropriate mechanism of injury. Operative versus nonoperative ma
- Alcohol intoxication and poisoning
Essential Evidence Topics, 30-Jan-2022
Overall Bottom Line: Diagnosis of alcohol intoxication is made by history and physical examination. A positive blood alcohol concentration (BAC) is helpful to secure the diagnosis but does not correlate with the degree of intoxication or self-perceived in
- Amphetamine toxicity
Essential Evidence Topics, 3-Jul-2022
Bottom Line: The most used amphetamines are MDMA (methylenedioxymethamphetamine, "Ecstasy," "Adam"), MDA (3,4-methylenedioxyamphetamine, tenamfetamine, "Eve"), and recently PMA (paramethoxyamphetamine). Amphetamine overdose can range from agitation and eu
- Anaphylaxis
Essential Evidence Topics, 18-Dec-2019
Overall Bottom Line: The diagnosis of anaphylaxis is made clinically. Attend first to airway, breathing, and circulation. Epinephrine and oxygen are the most important interventions. Laboratory tests may help confirm a diagnosis of anaphylaxis. Prop
- Ankle injury
Essential Evidence Topics, 5-Mar-2021
Overall Bottom Line: Use Ottawa ankle rules to determine whether x-ray is necessary to rule out fracture. Use Protection, Rest, Ice, Compression, Elevation (PRICE) mnemonic to guide conservative initial therapy. Nonsteroidal anti-inflammatory drugs (N
- Arsenic poisoning
Essential Evidence Topics, 27-May-2021
Overall Bottom Line: Drinking water should contain less than 10 mcg/L of arsenic. Chronic arsenic poisoning is associated with abnormal skin findings, peripheral neuropathy, and certain cancers (lung, bladder, and skin). A 24-hour urine test for quant
- Barbiturate toxicity
Essential Evidence Topics, 6-Jul-2022
Bottom-line: Obtain objective proof, when possible, of the time, quantity, and amount of the ingested product. Treatment is supportive. Ipecac or cathartic treatment should not be used; activated charcoal may prevent further absorption of ingested phe
- Benzodiazepine toxicity
Essential Evidence Topics, 4-Jan-2023
BOTTOM LINE: Clinical presentation generally consists of CNS depression, drowsiness, slurred speech, nystagmus, coma, respiratory depression, and hypotension. Address the ABCs (airway, breathing, circulation). Do not give ipecac or activated charcoal wi
- Biceps tendinitis injection (procedure)
Essential Evidence Topics, 16-Feb-2021
Indications for the Procedure: Patients with biceps tendonitis typically present with pain in the anterior shoulder. The pain is usually localized to the bicipital (intertubercular) groove, but can radiate down the arm to the hand or to the deltoid muscle
- Bite (dog and cat)
Essential Evidence Topics, 16-Sep-2021
Overall Bottom Line: Aggressive local care with copious (150 mL or more) of moderate intensity pressure irrigation is vital for all wounds. Animal bites to the hands should receive antibiotic prophylaxis (see ). Prophylactic antibiotics for dog and ca
- Bite (insects and spiders)
Essential Evidence Topics, 26-May-2022
Overall Bottom Line: DEET-containing repellents offer the most protection from insect bites. Insecticide-treated clothing and bed nets reduce insect bites. Patients with prior severe systemic reactions to insect bites/stings should carry self-injectab
- Bite (marine envenomations)
Essential Evidence Topics, 13-Feb-2022
Overall Bottom Line: Suspect envenomation after any marine injury. Treat all vertebrate fish envenomations with hot water bath and analgesics. Consider presence of foreign bodies. Treat sea urchin envenomations with hot water immersion, analgesics, an
- Bite (snake and scorpion)
Essential Evidence Topics, 11-Jan-2021
Overall Bottom Line: Seek immediate transport to a medical facility for any suspected snake or scorpion envenomation; keep the patient calm and quiet. Monitor vital signs and signs and symptoms of progressive deterioration enroute to the medical facilit
- Bloodborne pathogen exposures
Essential Evidence Topics, 3-Aug-2021
Bottom-Line: Engineering and environmental interventions may reduce the incidence of needlestick and other sharps injuries. At the time of a potential bloodborne pathogen exposure (BBPE), test the source patient for human immunodeficiency virus (HIV) infe
- Blunt abdominal trauma
Essential Evidence Topics, 30-Jan-2022
Overall Bottom Line: In all patients with a suspected abdominal injury, conduct a primary and secondary survey and a focused assessment for the sonographic examination of trauma (FAST) examination. Physical examination is not reliable in patients who ar
- Burns
Essential Evidence Topics, 25-Oct-2021
Overall Bottom Line: Assess patients with basic life support measures, and then assess the severity of the burn by estimating its depth and size. Obtain basic laboratory tests (CBC, electrolyte levels, renal function, UA, type and screen) and a chest x-
- Carbon monoxide poisoning
Essential Evidence Topics, 27-Jul-2021
Bottom-line: Carbon monoxide (CO) poisoning is one of the most common causes of accidental toxic poisonings and deaths. Suspect CO poisoning in patients with possible CO exposure and fatigue, dizziness, headache, unconsciousness, shortness of breath, an
- Child abuse and neglect
Essential Evidence Topics, 18-Aug-2021
Bottom Line: Child abuse and neglect are prevalent medical and social issues. Providers have a professional and legal obligation to follow-up on clinical suspicions of child abuse or neglect. Appropriate responses should be multidisciplinary (medical,
- Coccygeal injury
Essential Evidence Topics, 1-Nov-2022
Overall Bottom Line: The most frequent cause of coccygeal injury in adults is trauma. Physical examination may reveal ecchymosis in the acute stage, localized sacrococcygeal joint pain and tenderness, and pain with sacrococcygeal motion on rectal examin
