Chest Pain Admission: Should This Still Be a Thing?

  All of us have looked a patient’s past medical history, his/her triage note, chief complaint of chest pain, and instantly knew that patient was headed for admission despite a normal EKG and negative troponins. But are we doing more harm than good in admitting low risk chest pain patients with 2 negative biomarkers, stableRead more

P or Iup?

A G1P0 10-week pregnant female presents to the ED with lower abdominal pain and vaginal spotting. She’s had no prenatal care. Being the highly motivated resident that you are, before even the urine is collected and the pregnancy is verified, you bring the ultrasound machine bedside and see this: What’s the diagnosis?Read more

Epistaxis Management: Go Beyond the Dad Bod

  Earlier this year at a conference, I met a vendor from the makers of Rapid Rhino who compared the device to the Dad Bod: it’s old and not sexy like this, but it gets the job done and everyone has them (or used them) at some point in their careers. In fact, it evenRead more

Activate the Cath Lab? Not So Fast.

The traditional teaching (and pre-2013 ACC/AHA guidelines) for a new left bundle branch block (LBBB) on EKG (shown above) is that it is a STEMI equivalent and the cath lab should be activated. However, recent evidence in the last several years have shown that a new LBBB in and of itself is not indicative ofRead more

Stroke or Discharge?

It’s 4pm on Monday and you’re the resus resident at Sinai with all 5 beds full and 2 more waiting in the hallway. Despite channeling your inner Stephanie Hernandez you’re still completely overwhelmed. The triage nurse calls yet another resus patient overhead and this time it’s a stroke alert. You see this patient in triage:Read more


      Yesterday, the 7th mortality from legionella in NYC occurred. There have been 71 cases since July 10, all of them in the South Bronx after Legionella was found in cooling towers. This bacteria typically live in reservoirs of water or humidified spaces. It is a common cause (2 to 9 percent) ofRead more

Doc, I Have 10/10 Pain!

Pain control is one of the primary responsibilities of an emergency physician. At our disposable are a variety of medications and procedures (nerve blocks, etc) we use at our discretion based on the severity of pain, effectiveness of analgesia, time to administer, and side effects of the treatment.Read more