Blog

Rural Pearl – There is no hand

You have just recently started a lucrative position in a small rural hospital in Northern Vermont.  In your first week you are working a single provider overnight shift and a patient presents for a laceration to their left hand.   History: 25 year old right handed male, at home cutting a steak when the knifeRead more

Cystic Fibrosis in the Emergency Room

This series is designed to discuss topics that we might not routinely encounter during our training or how to manage patients we would normally triage to a sub-specialty service.   This pearl comes courtesy of an excellent review on emDoc. “Cystic Fibrosis ED Management Pearls and Pitfalls” http://www.emdocs.net/cystic-fibrosis-ed-management-pearls-pitfalls/   Basic Pathophysiology: Cystic Fibrosis (CF) isRead more

Buruli Ulcer

The following scenario is based on a case that was seen in the Sinai ED this past week. A 52 yo M with hx of poorly controlled DM and HTN p/w rapidly progressing ulcer over the past 3 weeks of right lower extremity.  He has been afebrile and has normal vital signs in the ED.  OfRead more

52 in 52 – Interrupted vs continuous compressions in cardiac arrest

Title: “Trial of Continuous or Interrupted Chest Compressions during CPR” Article Citation: Nichol G, Leroux B, Wang H, Callaway CW, et al; ROC Investigators. Trial of Continuous or Interrupted Chest Compressions during CPR. N Engl J Med. 2015 Dec 3;373(23):2203-14. PMID: 26550795 What we already know about the topic: Animal models have demonstrated that interruptions in cardiac arrestRead more

Spanish Phrases Parte Dos

Must Know Spanish Phrases: We are going to discharge you – le vamos a dar de alta You can go home today – Hoy se puede ir a casa You need to be hospitalized – Necesita ser hospitalizado You have to stay in the hospital – Tiene que quedarse en el hospital You will beRead more

EKG: Bradycardia and LBBB

A 75 year-old male with a history of systolic heart failure, hypertension, diabetes, hyperlipidemia, and COPD presents with complaints of shortness of breath to the ED. he presents with this ECG. A quick look at this ECG demonstrates bradycardia with 3rd degree heart block, left bundle branch block (LBBB) morphology, and possibly ST elevation. TheRead more

Ultrasound Uses that You Don’t Know About

Inspired by the mysterious and salacious Jon Mishoe. Trying to explain ultrasound via text just won’t work. Instead I will attempt to describe various ultrasound concepts and possibilities and I encourage you to grab ultrasound faculty for hands-on demonstrations if the clinical scenario is appropriate. Given the small amount of subcutaneous tissue and small surfaceRead more

Combined corticosteroid and antiviral treatment for Bell palsy

Title: “Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis.” Article Citation: de Almeida JR, Al Khabori M, Guyatt GH, Witterick IJ, et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis. JAMA. 2009 Sep 2;302(9):985-93.PMID: 19724046 What we already know about the topic: Bell Palsy,Read more

Hey Guys, welcome to the Sinai Spanish Series brought to you by your TR Zac. I thought I would start with some basics that might help with communication  at Elmhurst. Remember if you don’t speak Spanish all important conversation should be conducted with the help of an interpreter. All verbs below are posed in theRead more

Hypothermia ECG

For our clinical pearl today I thought I thought I would do some basic ECG teaching. This is a real case that I saw with Carlo at Elmhurst in the cardiac room. As always, we will start with a clinical scenario. A middle-aged male with unknown medical history was brought to the emergency department byRead more