EM Resident Conference by Julia Chiemi (05.11.21)

I had the privilege of attending an Emergency Medicine Resident Conference and listening to two amazing presentations from our EM physicians at RRED. Dr. Hendey gave an incredibly informative and in-depth ortho lecture on upper extremity dislocations and different techniques for reducing dislocations. In the ED, dislocations are one of the most common issues to present, but I had no idea how quickly and effectively they can be treated at triage with little to no downtime. Dr. Hendey explained a variety of techniques that can be used for closed reduction of fractures, and I was surprised to see the residents in attendance chiming in with comments about their preferred techniques for treating fractures and which methods tend to work for them. Dr. Hendey also touched on the different options for analgesia including local anesthetic and nerve blocks to prepare the area, as well as when vs. when not to order imaging of a dislocation. This was especially interesting to me, as EMRA’s AbdCT study is concerned with decision making factors that lead to ordering CT scans in blunt trauma patients. In the case of dislocations, x-rays are necessary to confirm that a fracture has not occurred, but if a dislocation diagnosis can be made, exposure to imaging can be avoided if there are not contraindications.

Next, Dr. Weingrow gave an excellent presentation on pelvic ultrasounds to diagnose intrauterine pregnancies (IUPs) in the ED. This is a lecture that gave me a lot to think about, especially given the disparity in women’s obstetrical outcomes across SES in the United States. The difference in structural visualization between a transvaginal and transabdominal ultrasound was explained in great depth, as well as the different locations in which ectopic pregnancies can occur. Finally, I learned that intrauterine device (IUD) use for contraception and assisted reproduction/IVF can actually be large risk factors for an IUP. Overall, I had a wonderful time learning from the amazing physicians presenting, and thank EMRA and the EM Faculty at UCLA for an excellent educational opportunity.