Automatic Blood Pressure Cuffs: Sorcery or Engineering

Did you ever wonder how your automatic blood pressure cuff actually works? No? Just me? Well…no surprise there. When the machine inflates the cuff, its goal is to get it above the patient’s systolic blood pressure (table how it knows that for one second). It then uses this as its estimate for the next timeRead more

The 52 in 52 Review: ProCESS

Title: “The 52 in 52 Review: ProCESS” Article Citation: ProCESS Investigators, Yealy DM, Kellum JA, Huang DT, et al. A randomized trial of protocol-based care for early septic shock. N Engl J Med. 2014 May 1;370(18):1683-93. PMID: 24635773. What we already know about the topic: Rivers shocked the world in 2001 with his revolutionary, if cumbersome, protocol forRead more

Spin to Win

Dr. Michael McGonigal’s Trauma Professional’s Blog is a fantastic web resource with a nice, free monthly newsletter. I’ve been reading it regularly since medical school, and I’m pretty sure it’s the first place I remember learning the trick of rotating a chest x-ray 90 degrees when looking for rib fractures: Your mileage may vary, but there’sRead more

A Whole New World

We all love FOAM, and we all love airway. Today’s pearl will introduce you to a corner of FOAM you may not have come across, as well as a corner of airway management you might not know about. I’m a big fan of Jed Wolpaw’s Anesthesia and Critical Care Reviews and Commentary podcast. Many ofRead more

The 52 in 52 Review: POCUS for Identification of Low CVP

Title: “The 52 in 52 Review: POCUS for Identification of Low CVP” Article Citation: Nagdev AD, Merchant RC, Tirado-Gonzalez A, Sisson CA, Murphy MC. Emergency department bedside ultrasonographic measurement of the caval index for noninvasive determination of low central venous pressure. Ann Emerg Med. 2010 Mar;55(3):290-5. PMID: 19556029 What we already know about the topic:Read more

Hard Numbers and Blood Transfusions

Not infrequently we identify patients who need to have some sort of blood product transfused in the ER. Most of these patients are not crashing, and have time to have a formal conversation about risks, benefits, and alternatives to transfusion. Of course you know all of the risks associated with transfusion (you do know them,Read more

Oops…is that part important?

There you were, minding your own business when EMS brings you a sick-as-can-be patient, intubated in the field for who knows what. Someone gets overzealous with their trauma shears and cuts off the pilot balloon on the endotracheal tube. This happened to me twice in my PGY2 year. Obviously, this ETT will need to beRead more