What is Kaplan’s lesion? Metacarpophalangeal (MCP) joint dislocation: Complex (Irreducible) Dorsal Mechanism of injury: Hyperextension injury Involvement: Usually occurs on border digits (Index > Little finger) Characteristic position of index finger: Hyperextended at MCP rests on dorsum of metacarpal Deviated towards middle finger Slightly flexed middle & distal phalanx with…
Category: Emergency Medicine
The Real Emergency Room scenarios, cases and topic reviews. Medical emergency conditions – approach to diagnosis and management.
Emergency Medicine 
LRINEC score for Necrotizing fascitis – Mnemonic
The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score is a tool to distinguish ordinary skin infections from necrotizing fasciitis. Mnemonic: NeC WASH Na level: <135 mmol/L: 2 points Creatinine: >1.6 mg/dl: 2 points WBC: <15,000/cu.mm: 0 points 15,000-25000/cu.mm: 1 point >25,000/cu.mm: 2 points Acute phase reactant (CRP): >/= 150:…
Clinical Skills and Approaches 
FARES method of Shoulder Reduction
Indication: Anterior shoulder dislocation Position of patient: Supine Position of physician: Standing on the side of the dislocated shoulder Steps: Physician holds the wrist of the patient with both the arms keeping elbow of the patient extended and forearm in neutral position Arm is slowly abducted in brief oscillating movement…
Emergency Medicine 
Acetaminophen (Paracetamol) Poisoning: Mnemonic Approach
Rule of 150 and 4 a. Begin treatment if: Paracetamol is ingested at a dose >150 mg/kg Threshold to begin treatment is half the dose (75 mg/kg) in high risk cases: 1. Regular ethanol consumption: >21 Units/week in male and >14 Units/week in female 2. Regular use of enzyme inducing…
Emergency Medicine 
DKA : Mnemonic Approach and Clinical Aspects
Diagnostic criteria for DKA a. Plasma glucose (mg/dl): >250 b. Arterial pH: 7.25 to 7.3: mild DKA 7 to 7.24: moderate DKA <7: severe DKA c. Serum bicarbonate (mEq/L): 15 to 18: mild DKA 10 to 15: moderate DKA <10: severe DKA d. Urine and serum ketones (nitroprusside reaction): Positive…
Emergency Medicine 
ATLS 80/70/60 Rule for Palpable Blood pressure
ATLS’ 80/70/60 rule On the basis of location of pulse palpable, minimum systolic blood pressure can be predicted as follows: Radial/Dorsalis pedis/Popliteal pulse: >80 mmHg Femoral pulse: >70 mmHg Carotid pulse: >60 mmHg Overestimation of SBP by Pulses Pulse characteristics are an unreliable sign and “should be used only as…
Emergency Medicine 
Testicular Torsion
Learning Objectives List the differential diagnosis for an acutely painful scrotum. Understand the anatomical basis of testicular torsion. List common presenting signs and symptoms of testicular torsion. Describe both initial and definitive management of testicular torsion. Explain why torsion is an emergent condition and discuss the time for salvage of…
Emergency Medicine 
Upper GI Bleed (UGI Bleed) Scoring : Mnemonics
Blatchford Score Blatchford score is recommended by NICE for 1st assessment. Admission risk marker Score component value Blood Urea (mg/dL) 18.2-22.4 2 22.4-28 3 28-70 4 >70 6 Haemoglobin (g/L) for men 12.0-12.9 1 10.0-11.9 3 10.0 6 Haemoglobin (g/L) for women 10.0-11.9 1 10.0 6 Systolic blood pressure (mm…