A 69 year old man is brought in by EMS with complaints of chest pain. ALS noted pt to be in sinus bradycardia in the 30s en route. As you approach the room you wrack your brain: what are the common causes of bradycardia? More importantly - will I get to actually perform a transvenous pacemaker i.e. the most highly sought after procedure as an emergency medicine resident?
Read moreSubmitted by Richard Byrne, MD
Your two minute review on right and left bundle branch blocks - brought to you by Dr. Kate Billings.
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A 49-year-old woman was intubated for acute hypoxemic respiratory failure secondary to pneumonia, which was complicated by empyema. She failed extubation and ultimately required tracheostomy for prolonged mechanical ventilation. After transfer to the intermediate care unit, she was successfully weaned from the ventilator for over 24 hours. She tolerated prolonged deflation of her tracheostomy cuff and swallowed water without aspiration. She underwent a tracheostomy tube occlusion test and there was no obstruction to air flow with a size 7 fenestrated tracheostomy tube in place. She is requiring suctioning once every 12 hours. You are assessing her readiness for tracheostomy decannulation and are considering the utility of a capping trial.
Read moreSubmitted by Emily Damuth, MD
Dr. Murphy discusses Methemoglobinemia.
Read moreSubmitted by Emily Murphy, MD
With several anticoagulants now on the market, one needs to be well versed in the various reversal options in the setting of lifethreatening bleed (or if supratherapeutic on coumadin). Here's your quick review.
Read moreIt’s a familiar call ahead to the ED - an adult patient who is febrile, hypotensive, with suspicion towards infection. While setting up the room, the patient’s bedside nursing team asks if you’d like them to get saline or lactated Ringer’s (LR) ready for resuscitation. You wonder if there’s any new evidence examining the use of saline versus balanced crystalloids in the emergency department.
Read moreSubmitted by Lars-Kristofer Peterson, MD
Dr. Murphy discussed cyanide toxicity
Read moreSubmitted by Emily Murphy, MD