Thu, 10/31/2019 - 5:00am

Bradycardia is defined as a heart rate of less than 60 BPM. In the ED, we may not always have the time to stop to consider the etiology of bradycardia after we have stabilized our patient (and after we likely already consulted cardiology!) Having a thoughtful approach to the differential diagnosis for bradycardia can be extremely helpful in treating the underlying cause. The next time a bradycardic patient presents to your ED, think to yourself, “The Brady Bunch is on a DIET.”

 

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Wed, 10/30/2019 - 9:00am

An 82 yo F with a history of HTN, DM, CAD, GERD presents to the ED with expressive aphasia that started 1hour prior to arrival. On exam, she has difficulty answering questions but follows commands. CT head is negative, neurology in consulted and tPA is given.

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Tue, 10/29/2019 - 8:08pm

A 56 year old male presents to the ED with confusion and abdominal pain. You notice a fistula in his upper extremity. A tech hands you his triage ECG and you scrutinize it for the tell-tale signs of a common, life-threatening diagnosis in hemodialysis patients, while wondering what the initial steps in management are....

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Mon, 10/28/2019 - 5:00am

Always good to review principles of statistics. Here we discuss reliability and the kappa score -

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Sun, 10/27/2019 - 5:00am

Ultrasound cases from the Coop! 

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Sat, 10/26/2019 - 5:00am

 

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Fri, 10/25/2019 - 5:45am

A 44-year-old man with a history of cardiac arrest complicated by hypoxic-ischemic encephalopathy presents to the ED in respiratory distress. He underwent tracheostomy 2 weeks ago for acute respiratory failure and was subsequently weaned to trach collar. He developed acute onset of respiratory distress at rehab this morning and now presents to the ED with acute hypoxic respiratory failure. On exam, he is hypertensive (169/88), tachycardic (HR 178), tachypneic with respirations assisted with bag-valve mask (BVM) ventilation and hypoxemic (SpO2 87%). What is your approach to the management of tracheostomy emergencies?

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Wed, 10/23/2019 - 12:10am

 

 

A 2 yo female presents with fever and difficulty swallowing

 

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Tue, 10/22/2019 - 10:31am

A 41 yo male is brought in by EMS after self inflicted stab wounds to the neck and chest. As the patient is transferred to the ED stretcher, you frantically try to recall the initial priorities in the management of this potentially deadly injury....

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Mon, 10/21/2019 - 5:00am

Everyone has seen the long list of causes of an anion gap metabolic acidosis. Why review it again? Because one day, whether in real life (or on your board exams...), thinking through this list will help make a tricky diagnosis. It is 'back to basics,' after all! 

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