Joseph Cesarine, MD

Brain Protection After Severe Injury: Hyperosmolar Therapy

Following a severe brain injury the goal of the clinician is to prevent secondary brain injury. This entails increasing oxygen delivery to the brain by preventing hypoxia and increasing cerebral perfusion. Hyperosmolar therapy, including mannitol and hypertonic saline, is often used to decrease ICP.

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The Basics of Tongue Lacerations

Lacerations of the tongue often require special consideration considering the tongue's anatomic location and functional importance. Repair of tongue lacerations are often plagued by patient intolerance and inadequate anesthesia of the area. This posts aims to introduce the basics of management of tongue lacerations. 

Managing Tongue Lacerations:

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Night Shift Aid?: Caffeine Impregnated Gum from the Military

Staying alert and functioning at a high level during an overnight shift in the Emergency Department is often a matter of life or death for your patients. Many of us employ the use of caffeine at all hours to combat the slow (sometimes rapid) creep of fatigue which hampers our skillset. Most providers can relate to those moments when a cup of coffee is just not what you are looking for. This post intends to introduce an alternative vehicle for caffeine designed for members of the military: Military Energy Gum. 

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GI Bleeding: The Evidence Behind When to Transfuse?

When patients present to the Emergency Department with acute upper GI bleeding, the natural inclination is to quickly pull the transfusion trigger. However, a 2013 study gives us pause:

Villaneuva et al. "Tranfusion Strategies for Acute Upper Gastrointestinal Bleeding." New England Journal of Medicine. 368:11-21.

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