Diagnosis and Management of Acute Joint Pain in the Emergency Department (https://www.ebmedicine.net/topics/musculoskeletal/joint-pain)Interview with author: Rachel Sullivan, MD* Why joint pain ?* Differential Diagnosis Mono vs Poly Articular Presentation? Figure 1Infectious, degenerative, autoimmune, crystal deposition, reactive, traumaticSeptic Arthritis-Bimodal incidence RisksSeptic arthritis is polyarticular in 15% to 20% of cases, and in these cases, the mortality is highGonococcal Highest riskCommonly affected jointsSymptomatic or asymptomatic infection Lyme ArthritisViral - Zika, chikungunya, human parvovirus B19, hepatitisDegenerative osteoarthritis AutoimmuneGoutCPPD* Prehospital * ED History - table 2, table 4* ED exam * Labs - do we need them? * Imaging* Arthrocentesis - Table 5* Treatment* Special PopulationsProstheses Immunocompromised HIV* Clinical Pathway

Episode 65 - Acute Joint Pain

Take a deeper dive into our peer-reviewed emergency medicine content with the EMplify podcast. Join hosts Sam Ashoo, MD and T.R. Eckler, MD for educational, conversational reviews of current evidence guaranteed to help you make your best clinical decisions. Each high-yield episode gives you practical, time-tested guidance from practicing emergency medicine clinicians and subject-matter experts. Listen and learn!

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In this episode, Sam Ashoo, MD and T.R. Eckler, MD interview Reuben J. Strayer, MD, author of the May 2024 Emergency Medicine Practice article, Current Concepts in Ketamine Therapy in the Emergency Department* Diving Into Ketamine Use in Emergency Medicine* Understanding Ketamine: From Origins to Emergency Use* Exploring the Ketamine Brain Continuum* Ketamine Dosing and Administration Techniques* Combining Ketamine with Neuroleptic Medications* Practical Approaches to Ketamine for Pain Management* Innovative Pain Management and Ketamine Use* Procedural Sedation with Ketamine: Techniques and Considerations* Addressing Agitation and Sedation in Emergency Situations* Navigating Intubation Strategies: DSI and Ketamine-Only Approaches* Ketamine's Role in Treating Asthma, Status Epilepticus, and Alcohol Withdrawal* Exploring Ketamine for Treatment-Resistant Depression* Concluding Remarks on Ketamine's Versatility in Emergency Medicine

Ketamine in the ED - An Interview with Reuben Strayer, MD

In this episode, Sam Ashoo, MD interviews Ashley A. Foster, MD, Bijan Ketabchi, MD, MPH and Jennifer A. Hoffmann, MD, MS on the March 2024 Pediatric Emergency Medicine Practice article, Evaluation and Management of Suicidal Ideation and Self-Harm in Children in the Emergency Department (https://www.ebmedicine.net/topics/psychiatric-behavioral/pediatric-emergency-medicine-suicidal-ideation-and-self-harm)* Introduction* Understanding Suicidal Ideation and Self Harm in Youths* Screening Tools and ApproachesAsk Suicide-Screening Questions (ASQ) Toolkit (https://www.nimh.nih.gov/research/research-conducted-at-nimh/asq-toolkit-materials)Columbia Suicide Severity Rating Scale (C-SSRS) (https://cssrs.columbia.edu/the-columbia-scale-c-ssrs/about-the-scale/)* Prehospital Care* Managing Patients in the ED* Dealing with Challenging Populations* Lethal Means Counseling* Emerging Tools in Suicide Risk IdentificationSuicide Risk Screening Pathway (https://www.nimh.nih.gov/sites/default/files/documents/research/research-conducted-at-nimh/asq-toolkit-materials/youth-ed/suicide_risk_screening_pathway_ed_youth_asq_nimh_toolkit.pdf)* Disposition and Referrals* National 988 Suicide & Crisis Lifeline  (https://988lifeline.org/)

Suicidal Ideation and Self-Harm in Children

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the April 2024 Pediatric Emergency Medicine Practice article, Brief Resolved Unexplained Events: Practical Evaluation and Management in the Emergency Department (https://www.ebmedicine.net/topics/cardiovascular/pediatric-emergency-medicine-brief-resolved-unexplained-event)* Introduction* The Evolution of BRUE* Understanding BRUE Guidelines* The Importance of Pre-Hospital Care in BRUE Cases* Investigating the Event: Questions to Ask* Medical and Family History: Key Factors* Environmental and Social Considerations* Definitions and Risk Assessment* Physical Examination* Risk Stratification: Low Risk vs. High Risk Patients* Management: What to Do and What Not to Do* High Risk Population: Studies and Recommendations* The Importance of Communication and Decision Making* 5 Things That Will Change Your Practice

Brief Resolved Unexplained Events (BRUE)

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the March 2024 Emergency Medicine Practice article, Emergency Department Evaluation and Management of Constipation (https://www.ebmedicine.net/topics/gastrointestinal/emergency-medicine-constipation)Prevalence and ImpactUnderstanding the CausesMedications That Can Cause ConstipationDealing with Fecal ImpactionUnderstanding Stercoral ColitisPre-Hospital CareED History and Physical ExamDiagnostic Studies and Imaging* X-Ray* CT Scans* Advanced TestingTreatment Options for Constipation* Enemas* Osmotic Laxatives and Stool SoftenersSpecial Considerations: Pregnant, Pediatric, and Hospice PatientsPrescription Medications for ConstipationClinical Pathway for Constipation Management

Constipation

In this episode, Sam Ashoo, MD interviews Paul Aronson, MD, MHS, one of the authors of the February 2024 Pediatric Emergency Medicine Practice article, Febrile Infants Aged ≤60 Days: Evaluation and Management in the Emergency Department (https://www.ebmedicine.net/topics/infectious-disease/pediatric-emergency-medicine-febrile-young-infant)Guideline ChangesPathophysiologyEtiology and DefinitionsPrehospital CareED History and Physical*  Diagnostic StudiesAge 0-21 Days*  Age 22-28 Days*  Age 29-60 DaysLumbar PunctureViral TestingUrinalysisShared Decision MakingDisposition

Episode 65 - Acute Joint Pain

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