Clinical Scenario A 24 y/o guy presents in ED with the left hand upraised. “I fell off my bike yesterday – he says – I remember a serious impact with…
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Clinical Scenario A 16 yo guy is brought in ED by his mother after a scholar accident. While he was running, he crashed. My son has a sore ankle!  Is…
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Clinical Scenario A 35 y/o male come to the ED because of pain in his right shoulder, he refers the pain started some month ago during a tennis match, the…
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Clinical Scenario It’s a Saturday busy night, in ED when a 31 yo male comes referring pain in the chin and next to the right ear after a trauma. He…
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Clinical Scenario A 50 y/o friend of yours called for you. He refers low back pain radiating to his left leg from approximately 2 weeks. “help me doc – he…
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Clinical Scenario Anthony, a 15 y/o student, slipped and fell while playng soccer. The next morning he refers continue pain on the right elbow. “Is it broken?” ask Anthony and…
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Clinical Scenario A 40 yo lady arrives in ED by ambulance with neck and spinalimmobilization because she fell down a stair care. The patient’s vital signs are within normal physiological parameters, sheis alert, no deficit, remembers all, denies head contusion and neck pain.She complains for a sharp shoulder pain (NRS 10/10), it seems broken. If I perform the Nexus C-Spine criteria  X Ray is indicated: a distractinginjury mandates cervical spine imaging. How much the presence of distracting injury reduces my sensibility in rule out cervical spine (c-spine) injury?   Conclusion   Once upon a time nearly all patients who presented in ED with blunt trauma received a cervical spine X-Ray. Theclinicians feared to undiagnosed a cervical fracture, with catastrophic consequences for the patients and than for thesame doctor, so there were a large number of unnecessary films. The Nexus five criteria simplified our work: it’s easy and speedy and especially is high sensitive to rule out a cervical spine injury. The presence of a distracting injury has anegligible impact. Is it time to define the Nexus four criteria?…
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A 33 y/o male comes to the ED for fever, knee swelling and pain. He has a history of joint surgery because of trauma, and prothesis, dating 4 years before.…
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A 33 y/o male comes to the ED for fever, knee swelling and pain. He has a history of joint surgery because of trauma, and prothesis, dating 4 years before.…
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