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In the spirit of FOAMed, we introduce WikEM Journal Club. Anyone worldwide can contribute, and each article review will build a list of must read articles for residents and practicing physicians. The best part, all journal club reviews are available offline using the WikEM mobile app.
To strengthen learning, we have a series of Dr. Amy Kaji’s review questions that can be added to the end of any journal review. (ie TTM) or you can write your own question using this example.… Read more
Tintinalli’s Emergency Medicine (7th Edition)
SECTION 25: ABUSE AND ASSAULT
Chapter 290: Child Abuse and Neglect
Chapter 291: Female and Male Sexual Assault
Chapter 292: Intimate Partner Violence and Abuse
Chapter 293: Abuse of the Elderly and Impaired
Pages 1975 – 1990
Chapter 100: Abdominal and Pelvic Pain in the Nonpregnant Female
Pages 672 – 676 (Tintinalli’s Emergency Medicine, 7th Edition)
Key Points and Pearls
- The bimanual exam is of limited value given its lack of accuracy and reproducibility for complaints such as CMT, adnexal tenderness or masses
- Ovarian cysts may cause pain when they rupture, precipitate ovarian torsion, or become large enough to cause pressure on adjacent structures
- Hormonal contraception is used to prevent cysts from forming (rather than to treat persistent functional cysts)
- Risk factors for torsion include ovarian cysts, tumors, pregnancy, and chemical induction of ovulation
- PID treatment includes ceftriaxone 250mg IM x 1 + doxycycline 100mg PO BID x 14 days + metronidazole 500mg PO BID
Chapter 39: Pain Management in Infants and Children
Tintinalli’s Emergency Medicine (7th Edition) pages 265 – 270
Key Points and Pearls
- Pediatric procedures should be performed with pharmacological and nonpharmacological adjuncts to minimize pain (analgesia), decrease anxiety (anxiolysis), and provide sedation.
- Fasting status has no correlation with aspiration. Preprocedural fasting is not required and only prevents a theoretical risk of aspiration, though no evidence supports this risk.