Blog

Put down that FOBT

“The HgB has dropped, have you checked a guaic?” How many times have you checked a FOBT in your workup for anemia? Let’s take a look at what FOBT is supposed to be used for. FOBT is a visual stool assay in which heme in the stool reacts with reagent hydrogen peroxide to oxidize guaiac, leadingRead more

A ‘normal’ chest Xray

What do you see when you take a look at this Chest radiograph? It isn’t immediately noticeable (and was read as normal), and is a good reminder of why you should always check your own films, and why a systematic read is important.  If all you were looking for was “r/o PNA/PTX” you could easilyRead more

Overshot that INR

There have been a few cases of supra-therapeutic INR in the Sinai ED recently, and at the request of one of our superstar interns, below you will find a brief set of recommendations regarding Supratherapeutic INR. The following bolded recommendations are for your patients who have no clinically significant bleeding: (These are recommendations based on AmericanRead more

Ketamine PSA with Desaturation

During a busy day in the ED, it becomes apparent that the pulling and yanking on your patient’s shoulder has done absolutely nothing to reduce their shoulder. You perform your pre-procedure PSA Checklist, know that this young and active 18 year old poses little difficulty, and push your desired dose of ketamine. Suddenly, you notice theRead more

Sinusitis In Pediatrics?

You’re working in pediatrics, when a mother comes in stating her 5 year old has sinusitis. He presents with fever, cough, runny nose, and some discomfort over where his frontal sinuses are. Does he have sinusitis? Not so fast! The ethmoid and maxillary sinuses develop during gestation, and are therefore present at birth. The sphenoidRead more

Ring Removal

Over the past week, we’ve had a strange uptick in number of patients presenting to the ER with rings stuck on their finger. This is a quick review on the options that you have regarding how to remove them. Assuming your patient has tried soaking their hand, and tried soap to remove it, there areRead more

TPA For Minor Stroke?

  So, you’re working in the ED when a new stroke code is activated. You walk over and see a young gentleman with the complaint of left facial tingling, right arm and leg weakness with some tingling. Overall though, a relatively well looking person with mild deficits. Neurology gets there, the patient is whisked offRead more