Thu, 06/18/2020 - 5:00am

A 69-year-old male with PMH of HTN, DM presents to the ED for chief complaint of vomiting. On evaluation, he states he “does not feel so good.” VS are BP 173/99, HR 74, Temp 97.1, RR 22, SpO2 99% on RA. You connect him to the monitor and see a wide rhythm. STAT EKG shows the rhythm below. What do you do next?

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Wed, 06/17/2020 - 12:10am

52 yo male c/o 4 days of left arm pain

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Tue, 06/16/2020 - 5:36am

An 8 month old is rushed into the pediatric resuscitation room. The nurse states he is unresponsive. As you enter the room, you wrack your brain to quickly develop a differntial diagnosis....

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Mon, 06/15/2020 - 5:00am

Shoulder reductions - you probably think you're pretty good at these. And you're probably right. But there's often more to learn, and a review of the basics many help tweak your approach or learn a new technique!

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Sat, 06/13/2020 - 5:00am

A 52 year old mal

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Fri, 06/12/2020 - 3:00am

A 72 y/o male with PMH type 2 diabetes, CAD, HFrEF, HTN, and HLD is admitted to the MICU for frequent neurologic monitoring after an endovascular thrombectomy for an acute ischemic stroke caused by thrombosis of the M2 branch of the left MCA. While reviewing his chart, you notice that the patient was recently admitted for 1 week about 10 days ago for dyspnea secondary to acute decompensated heart failure. You also note on his admission labs that he is newly thrombocytopenic, with a platelet count of 80,000. His last platelet count on discharge was 250,000, and he has never been thrombocytopenic before. What is causing his thrombocytopenia?

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Wed, 06/10/2020 - 7:53am

A 62 yo M presents to the ED with 1 week of abdominal distension with associated nausea and vomiting. He has had only 2 small bowel movements in the last week. He denies abdominal pain. On exam, his abdomen is distended and rigid. An obstruction series is obtained and shown below.

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Mon, 06/08/2020 - 5:00am

Last week we reviewed some causes of dental pain. Here we move into traumatic dental injuries, with an overview of types and management.

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Sat, 06/06/2020 - 10:00pm

 

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Fri, 06/05/2020 - 2:33am

 

A 52-year-old man with a history significant for hypertension presented to the emergency department with cough, dyspnea and fever. He progressed to severe acute respiratory distress syndrome (ARDS) secondary to COVID-19 pneumonia. He developed refractory hypoxemia with P/F < 60 mm Hg despite low tidal volume ventilation, paralysis, inhaled epoprostenol and prone positioning. Is this patient a candidate for venovenous ECMO and, if so, who should guide initiation and management of ECMO? The Society of Critical Care Medicine (SCCM) and Extracorporeal Life Support Organization (ELSO) recently published a position paper on the role of the intensivist in the initiation and management of ECMO. 

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