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#EMConf with @bryanmccartymd on Peds Ortho:

Kids bend, they don't snap.
Bends that stay bent without cortex breaking is called plastic deformation.

These still get splinted and do great, but still need reduction if >20⁰ bent.
When one side breaks and the other (near) side bends, that's a greenstick.

Periosteum torn on only one side, splint/reduce, maybe under sedation.

Torus/buckle is axial load, both cortices bent, typically no cast, removeable splint, may not need ortho F/U!
#EMConf
Both bones? Forearm w both cortices involved, even if one is greenstick or plastic deformity: less stable, procedural sedation and reduction.

Poss. OR when the reduction isn't stable.
#EMConf
Read 7 tweets
COVIDcast at @BaystateEM #EMConf today - If we could go back and have a "do-over" from 3 months ago....what would we tell ourselves about #COVID19, clinically? (1/)
We wish we'd known how important asymptomatic transmission of #COVID19 was (incredible modeling by @biomathematicus @JacobBAguilar medrxiv.org/content/10.110… (2/)
We wish we'd known our testing strategies for #COVID19 were quite flawed
1. (see asymptomatic transmission)
2. Co-infections on resp panel up to 21%
3. antibody tests have problems (Santa Clara Ab paper used test w/cross-reactivity, LFIA test characteristics aren't ideal) (3/)
Read 8 tweets
Dr. Bonnie Maldonado (@StanfordPeds) shares #COVID19 updates at the @StanfordEMED Town Hall.
🦠immunity is not durable once infected
🦠animals get coronas, and do NOT infect humans. However, human coronavirus on animal furs can spread the virus.

#PerspectiveNOTPanic #EMConf
Nasal swabs is a better test. A lot more virus in the nose than other parts of the body, which may explain droplet precaution.

#COVID19 #perspectiveNOTpanic #GetUsPPE #safetyfirst
Shedding may occur up to 48 hours before symptomatic. Asymptomatic may have lower viral load, and may not be as infectious, BUT STILL DO SHED AND ARE INFECTIOUS.

By 14 days, most people stop shedding.

#StayAtHome #COVID19 #ShelterInPlace #perspectiveNOTpanic
Read 8 tweets

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