Dislocation

Brief Summary The purpose of this study is to determine if artificial intelligence (AI) can assist doctors in detecting broken bones, effusions, dislocations and bone lesions more quickly and accurately in an emergency room setting. The study will also evaluate whether AI can save time and reduce costs in healthcare. The main questions to be addressed are: * Does AI improve the accuracy of detecting broken bones/dislocations/effusions/bone lesions? * Can AI expedite the process of diagnosing broken bones/dislocations/effusions/bone lesions? * Does AI reduce healthcare costs by enhancing efficiency? To investigate these questions, two groups of patients will be compared. One group will follow the traditional diagnostic approach, while the other group will utilize AI to assist in diagnosing X-rays. Participants in the study will: Undergo standard X-ray imaging of injured arms or legs, as part of routine care. Have X-rays reviewed by doctors with or without AI support, depending on the assigned group. The study will include patients of all ages presenting to the emergency room with an isolated injury or joint complaints. No additional tests or treatments beyond standard care will be involved.

Orthopedic injuries comprise more than 10% of ED visits in children and 25 to 50% of children will sustain a fracture before age 16 years. Distal radius fractures account for 20-32% of fractures in children, making them the most common fracture type. Between 20 and 40% of extremity fractures in children require a closed reduction, often necessitating procedural sedation and analgesia (PSA). Intravenous (IV) ketamine is the most commonly used sedative agent used to perform a closed reduction. However, children rate IV insertion as the most painful hospital experience, second only to the injury itself. IV insertion can be more technically difficult in children because of smaller veins and lack of cooperation, often leading to multiple IV attempts. A combination of intranasal (IN) dexmedetomidine plus ketamine (IN Ketodex) may provide effective sedation for children undergoing a closed reduction without the distress and pain related to IV insertion. A less painful experience has been found to correlate with child satisfaction which may reduce caregiver anxiety and improve the therapeutic relationship with the health care team. This study is a multi-centre, two-arm, randomized, blinded, controlled, non-inferiority trial designed to test the hypothesis that IN Ketodex is non-inferior to intravenous (IV) ketamine with respect to depth of sedation as measured using the Pediatrics Sedation State Scale (PSSS).

Study and evaluate the effectiveness of virtual reality in pain management.