Lauren Murphy, MD
A middle-aged woman with history of unilateral nephrectomy presents with a week of malaise progressing to disorientation, and is found to have a large obstructing kidney stone in her remaining kidney coupled with signs of severe sepsis and renal failure. Read ahead for management tips and additional pearls....
Whereas the dosing of sedative medications is usually unaffected, the chief concern is whether there should be changes for neuromuscular blockade – will your patient with myasthenia gravis require a higher or lower dose of your selected paralytic?
The Urine Drug Screen (UDS) is a commonly used test in the emergency department, however there are many shortcomings that limit its diagnostic utility. The Urine Drug Screen is exactly that – a SCREENing and not a confirmatory test! This week Dr. Lauren Murphy educated us on: 1) the potential false positives and negatives of the UDAS and 2) the detection times that drug metabolites are at a concentration in the urine to trigger a positive result (cutoff value). Read ahead for the reference tables!
After the awesome RESUS/EM conference last week, we return to our module of the month: Toxicology. This week Dr. Lauren Murphy has summarized the key points of her talk on the toxic alcohols. Knowing a little bit about toxic alcohol ingestion is very useful, as it is a fatal toxicity but treatable when recognized in a timely manner!
Today, EM Daily with Cooper Medical School hosted a number of local residency programs for the first RESUS/EM conference. These fantastic lectures will be available on EM Daily in a couple weeks, but to hold you over, here are some pearls from the day!
As the weather becomes nicer, more people are venturing outside to work on their yards, hike and just take in the sun - and hence, more people are becoming exposed to poison ivy, oak, and sumac. Learn the basic management for toxicodendron dermatitis.
Chvostek’s sign is momentary contraction of the nose and/or lips in response to tapping the facial nerve at the angle of the jaw. Associated with hypocalcemia, it has been found to be poorly sensitive and specific. It is seen in 10-25% of healthy individuals with normal calcium levels, whereas approximately one third of patients with hypocalcemia will not demonstrate this sign.