Not your average food coma

You are working a resuscitation shift when EMS calls in a young comatose male, ETA 3min. Tryptophan! His mother probably gave him too many leftovers, he tried to decline but she insisted because Go-gurt does not make for a balanced diet. Case closed. Then EMS arrives, tells you they tried narcan with no response andRead more

Thanksgiving Aftermath

You’re working Black Friday when a young diabetic female arrives to your ED complaining of abdominal pain and lethargy after eating every carbohydrate and gram of fat in sight yesterday. Who could blame her? She also stopped taking her insulin approximately 2 weeks ago. Being the astute physician that you are, you are concerned forRead more

Who put nuts in the pecan pie??

Grandma made it back to Thanksgiving safe and sound. But now, alas, cousin Scooter, who seems oddly illiterate regarding his nut allergy, eats a bite of pecan pie. Thankfully, you have an epipen, inject his thigh, and save the day. However, he continues to complain about a throat swelling sensation so you take him to yourRead more

Grandma v. Turkey…

Everyone is enjoying a fabulous Thanksgiving dinner when suddenly Grandma starts complaining that she can’t swallow, that something’s stuck, why didn’t you cut the turkey into smaller pieces, this is your fault, and now she’s not feeling thankful at all! It got dark, fast. She is in no respiratory distress, tolerating her secretions, and youRead more

Name That Poisonous Beast!: the Final Episode

In my last day as TR, I will end with a final “Name that Poisonous Beast!”.  Farewell, to poisonous beasts everywhere!  In this case, back in the garden. Name this poisonous beast! A) And it’s amphibian colleague: B)Read more

It’s Back! Name That Poisonous Beast! (reprise)

And back by popular demand, it’s another installment of “Name that Poisonous Beast!” Name this poisonous beast! A) And it’s stony neighbor: B)Read more

Shouldn’t I Just Give the Little Guy Some Albuterol?

You see a 20 month old with no PMH who has been wheezing and coughing for a few days.  His cousin has RAD.  Should you just give him a little albuterol and see how he does? Here’s his x-ray: What are you concerned for?Read more

Status – but What if the Seizing Doesn’t Stop?

Status epilepticus is one of the few neurologic emergencies.  Many protocols for persistent status involve dosing with a benzodiazepine, then another benzo, then an antiepileptic medication, and finally, continuous sedation with intubation.  The Sinai protocol is found here. But what if the seizing doesn’t stop?  How long can we wait for these medications to workRead more

Is Papain Back for Food Bolus Management?

What do you think?Read more

Can’t Sedate Me! I’m Allergic to Haldol.

A 24yo M with hx schizophrenia presents to the ED agitated, threatening staff and making gestures of self-harm.  You are unable to verbally deescalate him and go to order some sedative medication.  However, on his chart you see “Allergy: haloperidol”.  What does this mean?Read more