Joseph Cesarine, MD

Critical Cases: Tips for a Perfect Reduction

Do you feel like you pour your heart, soul, blood, sweat, and tears into your fracture/reductions and still come up short? Does the orthopedics consultant always want to "re-do" your attempt? Here is a repost of a podcast interview between former Cooper EM resident Patrick Sheehan, former Cooper Orthopedics Resident Joseph Legatol on how to get a perfect reduction. Inside the interview are 5 tips on positioning yourself for success. Also included is a video of Dr. Sheehan giving an example of "exaggerating the injury" of a distal radius fracture for a more successful reduction. 

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The AMPT Score: Do We Know Who Should be Transported By Helicopter?

Helicopter emergency medical services (HEMS) offers rapid transport to trauma centers while simultaneously providing advanced prehospital care. It is through these reasons that HEMS carries a survival benefit over ground emergency medical services (GEMS). However, increasing financial burdens and aviation risks to flight crews/patients complicate the decision to transport a patient by HEMS.

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Death and Survival Behavior in Cold Water

Cold water immersion is the most rapidly lethal environmental exposure on planet earth. This is illustrated by work-related death statistics obtained by the U.S. Coast Guard on commericial fishing vessels where death rates approach 180 deaths per 100,000 people per year and where 75% of these deaths result from fishermen falling overboard. The risk of death of cold water immersion on commercial fishing boats is quoted to be 15 times more deadly than firefighting.

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The Must-Know Complications of Supracondylar Fractures

Supracondylar fractures are the most common upper extremity fracture in the pediatric population therfore every emergency medicine provider should be deeply familiar with the known complications of such pathology. This post will introduce the types of supracondylar fractures and known complications.

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Misoprostol, Expectant Management, and the Evidence Behind Management Options of Incomplete Abortion

Miscarriage occurs in 10-15% of pregnancies. Historically, the "gold standard managment" for incomplete abortions was surgical dilation and curretage. However, the risk of infection, hemorrhage, cervical injury, uterine rupture, and anesthesia complications with routine surgical intervention opened the door for less invasive management options to replace conventional therapy. These options include medical (misoprostol) and expectant management. In today's practice of, Emergency Medicine providers are typically subject to varying practice patterns by obstetrics consultants.

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