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.
Oncological patients are at risk of developing several complications including life threatening infections. We often first worry about neutropenic fever in these patients. However, there are other oncological emergencies with which the emergency medicine physician needs to be familiar.
Delivering a baby in the emergency department is far from ideal and although all usually goes well, you need to be prepared in case it doesn’t. Shoulder dystocia gets a lot of hype because of those fancy corkscrew maneuvers, so instead of that we’re going to talk about another dreaded complication, post-partum hemorrhage.
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...
A 34 year old Vietnamese male presents with complaint of neck swelling. It began one month ago and worsened over the past few days. He endorses fatigue and a mild weight loss. Exam shows an indurated, non mobile mass without tenderness or erythema. You order imaging and are concerned for TB but unsure what to do next.