Insulin Bolus for DKA?….Not so fast

DKA is a very common endocrine emergency that we encounter very frequently in the ED in both pediatrics and adults. Standard therapy of care includes IVF, correction of electrolyte disturbances, +/- bicarb, and of course insulin. Prior to starting the insulin drip many providers administer an insulin bolus with the thought that it will overcomeRead more

Spontaneous bleeding is not the only side effect known to tPA

So you’re working a busy resuscitation shift when you are alerted by the triage nurse of a possible stroke with onset approx 1 hour ago. You go assess the patient and you find a 75 yr old gentleman with left sided facial droop, slurred speech, and left hemiparesis. The patient is rushed off to CTRead more