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Sinai Em Pearl 3/29

  STATUS EPILEPTICUS Persistent seizure >5minutes or recurrent seizures without return to consciousness in 5 minutes Initial Treatment Lorazepam (preferred over diazepam because longer t1/2 of distribution in CNS): 2-4 mg IV every 10-15 minutes (maximum dose 12mg) Fosphenytoin: 20 PE/kg IV at a rate of 150 PE/min or Phenytoin: 20 mg/kg at a rate of 50Read more

Sinai Em Pearl 3/28

What is a MSDS? Material Safety Data Sheets are a summary of the health hazards of the material and associated recommended safe work practices. MSDS are required by Occupational Safety and Health Administration (OSHA) to be sent by chemical manufacturers to the purchasers of their chemicals. As emergency providers we should be aware of whatRead more

Making Health Care Safer II

The AHRQ recently published an update to its landmark 2001 report, Making Health Care Safer: A Critical Analysis of Patient Safety Practices (AHRQ Evidence Report No. 43). This report advocated evidence-based practices such as root cause analysis, hand hygiene, ID bracelets for high risk patients, and time-outs prior to procedures. The 2013 update analyzed 41Read more

A review on INR reversal in patients taking coumadin.. Fresh Frozen Plasma: Prepared from single units of whole blood. It contains the majority of all major coagulation factors, but essentially no cells (eg, red blood cells or white blood cells) nor platelets. In addition to the all major coagulation factors, it also contains protein C,Read more

Sinai Em Pearl 3/19

A 36 year old male is brought into the trauma bay after involvement in a MVC. This patient was the unrestrained driver when he rear ended a truck at a speed of approximately 55mph. Per EMS, the air bag did not deploy and the patient did not lose consciousness. GCS 15 at the scene. HeRead more

Sinai Em Pearl 3/15/13

A 41 year old Riker’s inmate is brought in by EMS for reports of changes in mental status. The patient was found at the scene minimally responsive, with shallow respirations, and pinpoint pupils. Finger stick was 92. He was given 1.2mg of narcan by EMS with improvement of mental status. Upon awakening, he began toRead more

Daily Em Pearl 3/14/13

A 27 year old female presents with suprapubic cramping. Her LMP was 6 weeks ago. However, patient states “I can’t be pregnant because I have the paraguard” The mechanisms of action of the intrauterine device (IUD) are thought to be multifactorial and are primarily aimed at preventing fertilization. The fundamental mechanism is the production ofRead more

Daily Pearl

33 yo M presents with pain in left hand after being exposed to industrial cleaning product at work. Patient sates he feels a great amount of pain at the site and tingling radiating from the site. In the emergency room, he starts to have palpitations. He subsequently goes into ventricular fib. Patient is coded. WhatRead more

Daily Pearl

A friend calls you from the bar. He had 6 x 12 oz beers (5.7% ABV) over 2 hours.  He feels steady on his feet and not altered. He wonders if he is legally safe to drive home. If not, he wonders how long he should wait at the bar. He is a 38 yoRead more

Daily Pearl

What is the new surge policy?Read more