As EM physicians, we receive training in obstetrics. While most of us don't walk into a shift *hoping* for a delivery, we are trained to handle these cases if the present. Postpartum hemorrhage can be a complication of even a "normal" delivery. Read on below for some pearles regarding how to manage a postpartum hemorrhage.
Morgan Oskutis, MD
While we aren't dentists, it's very common to encouter ED patients with dental complaints. Dental blocks are a very useful tool in the care of patients with not only dental pain, but can also be used to anesthesize certain areas of the face for laceration repairs. Read on below for a guide on the different types of blocks.
Whether you use it or not, read this summary regarding the use of bicarbonate in metabolic acidosis
A patient presents with HIV and a fever...what's in the differential? Below is simple review of the differentials to consider for patients with HIV who present to the ED with a fever based on CD4 counts.
· Temperatures above freezing + wet conditions = immersion injury
· Commonly from continuously wearing wet socks and shoes
· Repeated exposure to wet and cold
o Homeless, military, outdoor workers
· Occurs over several days to weeks
· Tingling or numbness most common symptom
· Damp, pale or mottled in color
HINTS Testing: series of three physical exam maneuvers to differentiate peripheral and central causes of vertigo
Head Impulse test: tests vestibulo-ocular reflex
• Patient focuses on visual spot directly in front of them
• Rotate patient’s head rapidly from center to 40 degrees to the left and back again to center, repeat on the right
Last week we wrote about how to approach hyponatremia, the differential and signs and symptoms to watch out for. The post this week reviews the treatment of hyponatremia including the dreaded osmotic demyelination syndrome. Read on for more!