Emergency Care Updates

TMJ Dislocation Reduction Made Easy

 

Syringe Technique: With the patient in a sitting position, the physician places a 5 or 10 ml syringe between the posterior upper and lower molars or gums on the affected side. The patient is asked to gently bite down and grasp the syringe as the patient is instructed to roll the syringe back and forth, resulting in the reduction of the dislocated TMJ.

COPD Exacerbation – GOLD 2023 Guidelines

An exacerbation of COPD is defined as an event characterized by dyspnea and/or cough and sputum that worsen over < 14 days. Exacerbations of COPD are often associated with increased local and systemic inflammation caused by airway infection, pollution, or other insults to the lungs.

CT before LP?

  • If you think CT will show a cause for the headache, do a CT
  • If a CT is indicated for other reasons (depressed conscious level, focal neurology), do a CT
  • If a GCS 15 patient is to undergo LP for suspected (or to rule out) meningitis, and they have a normal neurological exam (including fundi), and are not elderly or immunosuppressed, there is no need to do a CT first.
  • If you’re seriously worried about meningitis and are intent on getting a CT prior to LP, don’t let the imaging delay antimicrobial therapy.
Emergency Medicine Kenya Foundation

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