Minor Injuries

“Minor injuries are an emergency departments bread and butter. This module aims to provide the you with tools and information to maximise your time in minors.”

BACKGROUND

On the face of it minor injuries would appear to be an emergency departments bread and butter. Increasingly it is an area of practice that is covered by allied health professionals and the exposure of junior ED doctors can be limited. This module aims to provide the you with tools and information to maximise your time in minors. 

It is also worth pointing out that some patients in minors may be labelled as "for doctor to see" or "doctor only" and so there are certain presentations such as back or head injuries that you may need to be especially familiar with.

Postgraduate exams may include the application of POPs, Wound Closure or MSK examinations and minors is the place to develop these skills.

Remember: Minors is also a very practical area to work in and it is worth taking the time to learn skills from colleagues such as physios and ENPs who have a wealth of experience in this area.

LEARNING OUTCOMES FROM Completing the TASKS

  • Apply the Ottawa ankle rules to patients with ankle injuries

  • Consider scaphoid injuries in diagnosing wrist injuries and recall the common mechanisms of injury

  • Review some soft tissue signs that suggest bony injury on x-ray

  • Recall the Salter Harris classification of epiphyseal plate injuries

  • Identify the bones visible on radiographs of the elbow

  • Consider the nerves at risk from specific fractures and how to test their function

  • Know how to classify depth of burns

TASKS

Complete the following before the face-to-face session:

Task 1: Radiology Masterclass

Duration: 45 mins

If you haven't found it already this website is a little gem and a good place to go to learn about X-rays. Before the session please complete the tutorials on:

  1. MSK General principles

  2. Introduction to trauma x-ray

These will give you the tools to be able to discuss x-rays in the face to face session. If you have time it is also worth completing the three other modules.

Task 2: Scaphoid Injuries

Duration: 30 mins

This is 10 question quiz from doctors.net aims to improve your knowledge of the diagnosis and management of scaphoid fractures. Who will get the high score?

Task 3: Ankle Sprains

Duration: 45 mins

Read this blog entry on ankle injuries and complete the questions as you go along. It covers ankle sprains and assessment, goes into some detail on the ligamentous structures of the ankle and includes a video of an ankle exam. There is also a description of the Ottawa ankle rules.

Task 4: Indentifying Fractures

Duration: 25 mins

This first video covers some soft tissue signs on x-rays that may indicate an underlying fracture, they are often subtle signs but will help prevent you missing injuries.

This second video covers the salter harris classification of epiphyseal fractures, as well as being a common exam question it is worth knowing for your time in paeds ED.

Task 5: Practice Cases

Duration: 5 mins

Complete the following short case, which illustrates why nothing in minors is "minor".

Task 6: Burn Injuries

Duration: 25 mins

Read this post by @PEMgeek covering some pearls on burns. She is a paediatrician summarising what she learnt on a course mostly about adults, but there is significant overlap when it comes to burns and it is well worth taking the time learn this.

#EM3 Content

Lightning Learning:

SIMBLOG

Mini Teaches:

Case Discussion

We have written a series of interactive cases (wikis) with short answer questions to be answered by trainees prior to the face to face teaching sessions. Currently this is only available to East Midlands Trainees.

Answer one or two questions before attending the face-to-face teaching session. Add comments to answers already given if you think it's appropriate. We will also provide tutor comments. If you find good resources that answer a question why not include links in your comment.

Part of the face-to-face teaching will be spent discussing the case(s) below:

“Answer the following regarding the ossification centres of an elbow X-ray...”
“For each of the following injuries please give the nerve(s) that could be damaged and how you would assess their function...”

ADDITIONAL RESOURCES

Here are some extra resources to review if you want more information:

Anatomy for Emergency Medicine:

Need a referesher on your anatomy? These videos are aimed at teaching anatomy relevent to emergency medicine and to cover the CEM syllabus. They are well worth a watch if you are a bit rusty and make for good revision for MCEM part A if you are considering emergency medicine. Specific videos include: multiple shoulder videos, scaphoid, scapho-lunate, colles fractures, Lis Franc and ankle injuries. They are also available via iTunes.

Upper Limb – Nerve Injuries:

A quick summary of nerves that can be injured, the mechanisms and examination findings. Curtesy of @drsarahedwards.

Sketchy medicine:

If you are a visual learner then this website is a must.

Joint Reduction Videos:

These excellent videos by @Lmellick from the US show how to reduce some of the common large joint dislocations that we perform in the ED. If you check out his youtube channel there are many more videos on a range of topics.

Course Feedback

Once you have worked through the exercises, discussed the example cases and attended the face-to-face teaching, please complete the following form:

Updated: 5th January 2017