Blog

Yes We Can!

Yes in fact we do have a massive transfusion protocol in place at Sinai.  It’s quite amazing and surprisingly simple as long as the tubing system isn’t down.  Follow the following steps. Call 46101 Ask for “Massive Transfusion Pack” Provide patient name and MRN Within 10 minutes, Blood Bank should tube you down blood products.Read more

Yet Another Reason Why We Don’t Perform Lvp in the Ed

The incidence of hemorrhagic complications from large volume paracentesis (LVP) is unknown but hemoperitoneum from rupture of mesenteric varices is associated with a high mortality up to 70%. Signs and symptoms of hemorrhage can manifest from hours up to 1 week after LVP. It has been proposed that a sudden reduction in intraperitoneal pressure fromRead more

Baby Momma Drama

As you know, pregnancy increases the risk of thrombosis.  This risk is even higher postpartum (within 6 weeks after giving birth).  Relative to the nonpregnant state, the 6 week postpartum period has been associated with 3-9 times risk of stroke, 3-6 times risk of MI, and 9-22 times risk of venous thromboembolism (VTE). Risk factorsRead more

Vf Arrest…simple Right? Maybe Not…

The vast majority of ventricular fibrillation arrest can be traced back to cardiac etiology (ie CAD, HOCM, myocarditis, etc). However there have been rare cases of v fib arrest secondary to nontraumatic SAH; one recently in our own backyard (Elmhurst)! Aneurysmal SAH is a relatively common cause of PEA, but VF arrest is almost unheardRead more

Correction

 cyproheptidine is a second-line therapy for serotonin syndrome. not SSRI overdose. the vast majority of SSRI overdoses do not result in serotonin syndrome. what kills people with serotonin syndromeis hyperthermia. the most important treatment for serotonin syndrome is supportive care, active cooling. Thanks Dr. Strayer for the correct infoRead more

There’s a Storm a Brewin’

When does one administer iodide as a treatment for thyroid storm? A.as soon as possible B.never C.it doesn’t matter D. 1 hour before administering a thionamide E. 1 hour after administering a thionamide F. 1 hour after administering a betablocker G. 1 hour before administering a beta blocker Answer : E.  if given earlier, the thyroid will useRead more

The Goggles…they Do Nothing!

  A patient presents with sudden onset eye pain.  He states he was watching his friend’s car get towed out of a snow drift that had suddenly appeared beneath it, when the towing cable snapped and the pain began.   He shows you this picture from his camera, taken right before symptom onset.    Read more