What is Emergency Medicine - Why does compartment syndrome exist?
​ When the pressure inside the cramped area of the muscle compartment exceeds the capillary filling pressures, muscular ischemia and edema occur. This condition is known as acute compartment syndrome (ACS). Necrosis of the muscles and nerves is the outcome of muscular ischemia, which in turn raises intracompartmental pressure and sets off a vicious cycle. ACS can be caused by any growing mismatch between a compartment's size and its contents.

What is Emergency Medicine -  What proportion of individuals with polytrauma have undiagnosed fractures at the time of admission?
​At the time of the initial evaluation, up to 20% of all patients who have been injured multiple times have undetected fractures. The wrist, hand, ankle, and foot are where these concealed wounds are most frequently found. This significant statistic emphasizes the demand for a secondary survey of individuals with multiple injuries. From the start of the patient's care, the family should be made aware of the possibility that later surveys may discover fractures and injuries that were not initially noticed.

.What is Emergency Medicine - Which open fractures require prompt attention?
​Open fractures require prompt orthopedic attention. Open fractures are evaluated during the secondary survey once any concomitant damage to important organs have been ruled out. Until proven otherwise, any skin break close to a fracture site should be assumed to communicate with the fracture. Apply a sterile dressing to the wound after thorough evaluation, including a neurologic and vascular assessment, and clear it of any significant contamination. Wound probing is not advised in the emergency department (ED) until absolutely necessary to stop bleeding. Direct pressure should always be applied to control hemorrhages.

​Splinting and axial realignment immobilize the bone, reducing blood loss and preventing additional harm to the soft tissue. Due to the increased risk of secondary contamination and soft tissue damage, avoid wound culturing, thorough irrigation, and repeated examinations of the wound. administer intravenous (IV) antibiotics and tetanus vaccinations. For antibiotic prophylaxis, a first-generation cephalosporin like cefazolin is most frequently used. Consider using piperacillin/tazobactam or adding an aminoglycoside in more severe open fractures, Gustilo-Anderson 3 fractures, and fractures that are severely contaminated.

​What is Emergency Medicine - What are pediatric intra abdominal surgery IAI predictors?
It is important to address IAI-causing factors such as high-speed car accidents, pedestrian auto accidents, bicycle accidents (including handlebar injuries), lap belt use, and direct impacts to the abdomen. For the purpose of identifying kids who are very unlikely to experience clinically significant IAI—defined as requiring a therapeutic laparotomy, angiographic embolization, blood transfusion for abdominal hemorrhage, or IV fluid for more than two nights for pancreatic/gastrointestinal injuries—a clinical decision rule has been validated. CT can be safely avoided in patients with the examination findings listed below: 1. There is no indication of abdominal wall damage or the seatbelt indicator 2. A GCS of 14 to 15
3. Absence of stomach pain
4. There was no sign of thoracic wall damage.
5. No reports of stomach ache
6. No diminished or missing breath sounds
7. No nausea

​What is Emergency Medicine - How frequent are pediatric mediastinal (great vessel) injuries? Children hardly ever suffer from mediastinal injuries. Aortic injuries are much less common in children than in adults due to the great compliance of the chest wall and flexibility of the ligamentous tissues of the mediastinum. The projected cancer risk from a chest CT in children has been demonstrated to exceed the positive rate of chest CTs in this cohort, hence chest imaging should be avoided in children without a strong pre-test probability for a blunt thoracic aortic injury.

What is Emergency Medicine -  What is cervical pseudosubluxation and how often is it?
​Children's C2 on C3 pseudosubluxation, a common anatomical variant, occurs when the C2 vertebral body is somewhat anteriorly displaced in relation to the C3 body. It occurs in roughly 40% of children under the age of seven and 20% of children up to the age of sixteen. It is caused by the normal mobility of the vertebral bodies in young children. Swischuk's line, which is drawn along the anterior edge of the spinous processes of C1 and C3, can be used to distinguish it from actual subluxation. If the line crosses the anterior spinous process of C2 at a distance more than 1.5 mm, injury is presumed.

What is Emergency Medicine - Should all young trauma victims undergo routine pelvic and chest x-rays?
​An abnormal thoracic examination, hemodynamic instability, severe cause, or during endotracheal intubation or thoracostomy tube insertion are indications for a chest x-ray. Young children seldom sustain pelvic fractures, and hemodynamically stable children of all ages rarely benefit from x-rays; instead, patients with severe pelvic pain or instability should get CT imaging.

​What is Emergency Medicine - Which young patients should get cervical spine MRI following trauma? Cervical spine imaging should be performed on kids who have neck pain, midline bone tenderness, limited range of motion, torticollis, disturbed mental status (GCS score 14), focal neurologic abnormality, predisposing factors, or temporary spinal cord symptoms. The majority of patients prefer plain radiographs (anteroposterior [AP], lateral, and odontoid views). Patients who have unsettling physical exam findings or abnormal plain radiographs should have a CT or MRI, and frequently both.

What is Emergency Medicine - What is SCIWORA?
Spinal Cord Injury Without Radiographic Abnormality is referred to as SCIWORA. Before thin-slice CT and MRI were widely available, the term "SCIWORA" was applied to children who had substantial spinal cord injuries but normal x-rays or CT scans (most commonly cervical). We now know that these injuries may be seen on an MRI and are more common in adults than in children. Children and adults who exhibit neurologic symptoms (radicular or myelopathic) but who have normal x-ray or CT scan results should have further MRI testing in the emergency department.

​Patients who experience short-lived, temporary symptoms of the spinal cord should also get an MRI because these symptoms could indicate spinal cord stretching, which could indicate delayed cord edema and recurring spinal cord disease. Patients who have persistent spinal pain or discomfort but no neurologic symptoms may be discharged in a rigid cervical collar with outpatient follow-up and an MRI if the pain doesn't go away.

​What is Emergency Medicine - How do injuries to the cervical spine in children and adults differ? Young children are more likely to sustain cervical spine injuries than older children and adults because of the anatomical movement of the cervical spine, which occurs from C2-3 at birth to C5-6 at age 8, and because pediatric cervical spine injuries are frequently linked to severe brain injury and respiratory arrest, which frequently results in death at the scene of the accident.