Tuesday

Recognize Dynamic Hyperinflation (Air-Trapping) at the Bedside Using the Flow Curve

Dynamic hyperinflation (autoPEEP, air trapping, etc.) is a process leading to an increase in end-expiratory lung volumes and increased airway pressures. This process may occur secondary to obstructive lung pathology and/or an increase in minute-ventilation without sufficient time for expiration. The pathologic effects of dynamic hyperinflation include an increased work-of-breathing, barotrauma, pneumothorax, and an increase in intrathoracic pressure leading to a decrease in cardiac output and possible hemodynamic collapse. Rapid identification of this process is crucial for reversing it.

Joseph Cesarine, MD
Tue, 01/03/2017 - 12:14pm
Topic: 
Critical Care
Pulmonology
Category (Day): 
Tuesday

Ottawa Aggressive Protocol: Treat and Street for Atrial Fibrillation?

Editor: 
Joseph Cesarine, MD

It’s another busy shift in the Emergency Department and you are seeing the third patient of the day in atrial fibrillation with rapid ventricular response. You think to yourself, “simple plan and disposition: stabilize, start on a diltiazem infusion, anticoagulate and admit to cardiology, right?” Well before you proceed with this well accepted approach, consider an alternative management strategy where you can even discharge the patient home!

Anita Bhamidipati, MD
Tue, 12/20/2016 - 6:54am
Topic: 
Cardiology
Category (Day): 
Tuesday

How to Not Miss a Posterior Myocardial Infarction

Editor: 
Joseph Cesarine, MD
Richard Byrne, MD
Stephanie Wilsey, MD

The anatomical location of a posterior myocardial infarction makes it's diagnosis not readily apparent. Intimate knowledge of standard and posterior ECG manifestations of posterior myocardial infarctions is crucial to picking up on this potential fatal pathology. This post aims to provide tips for evaluating patients for posterior myocardial infarction.

Anita Bhamidipati, MD
Tue, 12/13/2016 - 2:29pm
Topic: 
Cardiology
Category (Day): 
Tuesday

You Have Intubated an Asthmatic... Now What?: Initial Ventilator Settings in Severe Asthma Exacerbation

Editor: 
Joseph Cesarine, MD
Richard Byrne, MD

In the setting of a severe asthma exacerbation that is refractory to medical mangagment and noninvasive ventilation, mechanical ventilation can be life-saving. However, the ventilator can quickly kill your patient if careful thought is not taken to address the unique respiratory needs and pulmonary physiology inherent to severe asthma.

Samuel Eldrich, MD
Tue, 12/06/2016 - 1:44pm
Topic: 
Critical Care
Pulmonology
Category (Day): 
Tuesday

Interview with an Orthopedic Surgeon: Tips for a Perfect Reduction

Editor: 
Joseph Cesarine, MD
Richard Byrne, MD

Do you feel like you pour your heart, soul, blood, sweat, and tears into your fracture/reductions and still come up short? Does the orthopedics consultant always want to "re-do" your attempt? Here is a podcast interview between Patrick Sheehan, MD of the Department of Emergency Medicine and Joseph Legato, MD of the Department of Orthopedic Surgery at Cooper University Hospital on how to get a perfect reduction. Inside the interview are 5 tips on positioning yourself for success. Also included is a video of Dr.

Patrick Sheehan, MD
Tue, 11/29/2016 - 6:45am
Topic: 
Orthopedics
Tips
Trauma
Category (Day): 
Tuesday

Respiratory Failure: Indications for ECMO

Extracorpreal membrane oxygenation is a temporizing mechanical support to heart or lung function in the setting of cardiopulmonary failure. In the setting of severe respiratory failure, patients that may benefit from and/or have an indication for ECMO are described in the Extracorporeal Life Support Organization Respiratory Failure Supplement to ESLO General Guideline, December 2013:

Indications:

Joseph Cesarine, MD
Tue, 11/15/2016 - 7:33am
Topic: 
Critical Care
Pulmonology
Category (Day): 
Tuesday

Orthopedic Injuries Around the NFL: Dez Bryant 's Tibial Plateau Fracture

Editor: 
Joseph Cesarine, MD

In Week 3 of this NFL season, Dallas Cowboys wide receiver Dez Bryant suffered a non-displaced tibial plateau fracture against the Chicago Bears. In the news, the injury was labeled a "hairline fracture of the knee." The injury resulted from Bryant landing awkwardly on his leg while being tackled near the sideline. Bryant is expected to miss 4-6 weeks.

Andrew Nyce, MD
Tue, 11/08/2016 - 12:42pm
Topic: 
Orthopedics
Category (Day): 
Tuesday

Pages