Alexis Pelletier-Bui, MD

Back to Basics: Complete Heart Block

68yo Male, hx DM (+insulin pump), CHF (+lasix), HTN, presents to the ED c/o intermittent episodes of lightheadedness for the past year, becoming more frequent over the past month and had an episode today while getting out of bed. No syncope. At home noted HR 33, went to urgent care, HR 37. Patient was sent to the ED for further evaluation. What did the ECG show?

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Back to Basics: Hypercalcemia

A 70 yo female s/p thyroidectomy 1 month ago on supplements presents to the ED complaining of intermittent nausea and vomiting for the past week with intermittent abdominal pain today. She reports that stools in her colostomy bag are now hard x 3 days. You get some labs and the basic metabolic panel shows... 

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Back to Basics: Infantile Botulism

This post was inspired by a recent clinical case in our department. A 7 week full term infant s/p spontaneous vaginal delivery with a normal maternal prenatal screen and course presents to your ED for not eating x 12 hours. On exam, you note decreased spontaneous movements, a weak suck and a weak cry noted. Vitals are normal. What's the diagnosis? 

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Back to Basics: Ultrasound Guided Peripheral IVs 101

Ultrasound guidance has undeniably revolutionized IV access and is an incredibly useful skill for the ED physician.  The following are by no means a comprehensive guide to the procedure but rather 10 tips for small changes that are often overlooked and can make a huge difference. If you have trained with ultrasound guided IV’s and feel comfortable already with your own style, this may not be as helpful for you. For the medical students, interns, and perhaps "less young attendings" that did not have a vascular probe attached to their hip during residency, read on!

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