The Cat’s Out of the Bag

Noninvasive cardiac testing comes in multiple forms. There is the dobutamine or exercise stress echocardiography (DSE/ExSE), myocardial perfusion scintigraphy (MPS)–single photon emission computed tomography (SPECT), and cardiac magnetic resonance imaging (CMR). There is also a growing imaging technique CTA coronary studies which have come about due to the advances in CT technology allowing for fasterRead more

The Nerve!

You’re in your Intake/Fast Track shift and you see a 94 year old patient who had a trip and fall earlier today and now has elbow pain. The elbow is tender and xray shows a fracture dislocation. You call your local ortho and they want to do a closed reduction in the ED, but youRead more

Bite Me, Part Deux

So you’re working your pediatric shift again and you see a child who fell and hit his chin on a table and now has a tongue laceration which you’ve deemed needs repair (see prior post for criteria). How are you going to anesthetize the area in order to get the most comfortable procedure possible? BelowRead more

Cutting the Neck

You’re in a small community ED and the only overnight doctor and you’ve found yourself with a difficult airway. Direct laryngoscopy has failed, video didn’t get a great view, bougie was surprisingly unhelpful, your LMA isn’t the best, and now you’ve reached a point where you know you need a surgical airway. But you hesitate.Read more

Hard Headed

With the NFL Wild Card Weekend almost upon us, the talk of head injuries could never be higher. Professional athletes are evaluated by multiple physicians when at risk for a concussion, but what do you do when you have that 16 year old who hit his head playing basketball and now has a headache andRead more

Bite Me

You’re working your pediatric shift and you see your next patient. It’s a young boy who while running had fallen and hit his head, had initially had some bleeding from the mouth and was crying but is now better and no longer bleeding.  His mom brought him in cause she found a cut on hisRead more

The Weather Outside is Frightful

With the arctic blast sweeping through the country, the incidence of patients with severe hypothermia is likely to increase. So what do you do when you’re sitting in the cardiac room and EMS brings in a patient with a very low core temp? Lets review the techniques of rewarming that should be in your arsenal.Read more

Weathering the Storm

You’re in the resus room having your morning bottle of water when the triage nurse rolls in your new patient. Diaphoretic, talking but lethargic appearing, and, when placed on the monitor, showing this: Being the astute resident that you are, you know this is VT and the next step is cardioversion in an unstable patientRead more

Getting the Finger

Hand pain: a chief complaint that can be seen at any level of emergency medicine. But do you know what to do if your patient has finger trauma involving the nail and happen to be in a place without a hand service to consult your troubles away? Say you see your patient who had aRead more

Tis the Season!

Its a holiday weekend. The decorations are up. Presents will soon be unwrapped. A beautiful tree is decorated and lit. But did you know your living room of festivity can be a death trap in the making? For example, the beautiful holly on the window sill, if ingested, has a toxin named saponin which canRead more