Richard Byrne, MD
Can cheap, safe infusions of vitamins really succeed where so many hundreds of novel therapies have failed? The recent article in Chest by Dr. Paul Merik has taken the critical care world by storm, with reported mortality rates of 8.5% in patients treated with a simple vitamin C/thiamine cocktail (with none of the deaths directly attributable to sepsis). The skepticism and push-back have been nearly unprecedented, especially on #FOAMed. Whether you're a skeptic or an early adopter, you need to understand the basis for the debate by checking out this high-yield summary.
Pericardiocentesis is a rarely performed, but potentially life-saving procedure. Commerical models are prohibitively expensive, but students and residents (and critical care fellows) still need to learn the mechanics, ideally with an ultrasound compatibile model. This week's post gives a step by step guide towards making a cheap, easy to fabricate phantom based on this fantastic paper published in the Journal of Emergency Medicne 2012: https://www.ncbi.nlm.nih.gov/pubmed/21925818
Think just because you are a young, healthy physician that you are invinceable? Read this post and remember that we are vulnerable too...even more so because we often refuse to acknowledge when we are sick. This week's Advanced Practice topic comes to us courtesy of a Cooper EM alum. The story is told with full permission from the patient, his wife, though names are omitted to prevent any possible HIPPA entanglements!
Do you routinely perform large volume (or near large volume) paracentesis in your ED? If so, you need to know about a potentially life-threatening complication of this procedure...
Tranexamic Acid! It seems everywhere we look there are people touting TXA as the next miracle drug. This post introduces the clinical applications of TXA and the evidence supporting its use.
A 34 yo female with a history of trigeminal neuralgia presented to the Emergency Department with a chief complaint of 5 days of severe, worsening paroxysms of pain in the left trigeminal nerve distribution. The pain was refractory to carbamazepine and gabapentin. Neurology was consulted and an unconventional therapy was recommended.
Do you sound like a first year medical student when discussing hand injuries by phone with consultants? Forget all the tendon anatomy you crammed for in anatomy? FDP? FDS? FPL? Then check out this post for a "Back to Basics" online hand exam lecture by Dr. Fred Heckler from UPMC.