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.
Read moreSubmitted by Joseph Cesarine, MD
A high-yield review from the past week on EMDaily!
Read moreSubmitted by Joseph Cesarine, MD
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.
Read moreSubmitted by Joseph Cesarine, MD
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:
Read moreSubmitted by Grace Lam, MD
Your patient in the Emergency Department has a Zone II or Zone III finger amputation which requires primary closure of the wound prior to discharge with appropriate outpatient follow up. However, a protruding piece of bone often prevents closure of the skin flap and requires trimming by using a rongeur. While this process is typically carried out by an orthopedic or hand surgical consultant, this post aims to introduce the use of a ronguer during management of finger amputation in the Emergency Department.
Read moreSubmitted by Joseph Cesarine, MD
Case: A six week-old previously healthy, term infant via vaginal birth is brought to pediatric ED for repeated episodes of vomiting over a one week period. Vomiting occurs 20-30 min following every episode of feeding and is described as projectile. Parents note decreased urine output over the past two days. Patient is noted to be hungry following vomiting episodes
Read moreSubmitted by Lauren Murphy, MD
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.
Read moreSubmitted by Joseph Cesarine, MD
You have made the diagnosis of disseminated gonococcal infection in your patient presenting with history and physical exam findings suggestive of purulent arthritis, now what?
Read moreSubmitted by Joseph Cesarine, MD
,Submitted by Ross Kalman, MD
Thank you to everyone who has contributed to and enjoyed EMDaily. We are all looking forward to a great year in 2017. Come back in 2017 for more exciting FOAMed from EMDaily. Happy New Year!
Read moreSubmitted by Joseph Cesarine, MD
The most commonly used induction agent for rapid sequence intubation in the acutely injured patient is etomidate, largely due to its rapid onset of action and hemodynamically "neutral" effects.
Read moreSubmitted by Joseph Cesarine, MD