Mon, 11/04/2019 - 5:00am

Your quick guide to the management of bite wounds in the ED - dogs, cats, and humans - oh, my!

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Sat, 11/02/2019 - 5:00am

 

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Fri, 11/01/2019 - 6:00am

Case: A 34 year old female with no PMHX presents to the ED with unilateral right lower extremity swelling, dyspnea, and moderate pleuritic chest pain.  Vitals: BP 130/65, HR 68, RR 20, SPO2 89% on room air, Temp 37.8. A CT finds evidence of PE bilaterally at the segmental level. BNP and troponin are both mildly elevated.  Point of care cardiac ultrasound shows mild RV dilation. After interviewing the patient, you don’t identify any contraindications to anticoagulation. Pregnancy testing is negative.  Her renal function is normal. You consider what is the preferred agent for anticoagulation in this patient.

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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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