Congenital Adrenal Hyperplasia

A 1-week-old infant is brought in by his mother for decreased responsiveness and vomiting. Prenatal and birth history were unremarkable. He is cool, clammy, and lethargic. Nurses are unable to obtain a blood pressure, and he is hypoglycemic to the 30s. You establish IV access, send labs, and administer fluids and dextrose. He then beginsRead more

Paracentesis Checklist

One of the most frequent requests we receive as teaching residents (and probably as senior residents) is assistance with performing paracenteses. By now, all of the EM residents are probably comfortable with this procedure. But, July is coming! With it comes newly minted doctors and off service rotators who are eager to learn. Feel free toRead more

Red Man Syndrome

Today in resus, the nurse told me that one of the patients, a woman being treated with vancomycin, began to appear flushed and kept itching her face. The patient denied respiratory or GI complaints. She denied previous drug allergies, and had received vancomycin in the past without issues. Just like the rapper in the imageRead more

52 in 52: Dexamethasone in Mild Croup

Bjornson CL, Klassen TP, Williamson J, Brant R, et al; Pediatric Emergency Research Canada Network. A randomized trial of a single dose of oral dexamethasone for mild croup. N Engl J Med. 2004 Sep 23;351(13):1306-13. PMID: 15385657   What we already know: Croup, also known as acute laryngotracheobronchitis, is a disease that commonly affects the pediatricRead more

ACEP Clinical Policy: TIA

In 2016, ACEP published “Clinical Policy: Critical Issues in the Evaluation of Adult Patients with Suspected Transient Ischemic Attack (TIA) in the Emergency Department” in the Annals of EM. Here is a brief refresher. Transient ischemic attack (TIA) is a part of a spectrum of ischemia affecting the central nervous system. “Transient episode of neurologicRead more

Brachial veins

When assessing patients with difficult peripheral venous access it is often helpful to look in the medial upper arm. Here, the brachial artery (A) and veins (V) are predictably located between the biceps and brachialis muscles. The median nerve (N) resides there as well. Here’s a plate from Grey’s Anatomy for some perspective: So howRead more

Giving a great talk

Lots of inspiring speakers at today’s academic retreat. I had ten minutes to give my opinion on how to give a great talk, and referred to a few great books to help: My opinion? Craft a powerful message and find the best tools at your disposal to convey it. Easy!Read more

SonoSweden 2015

Bret Nelson and Felipe Teran took part in an incredible conference just outside of Stockholm, Sweden. Over one hundred participants and twenty faculty attended this sold-out conference at the Hasseludden Yasuragi Japanese spa . Among the luminaries were Matt Dawson and Mike Mallin (from the Ultrasound Podcast), lung ultrasound queen Vicki Noble, Mike Lambert andRead more

WCUME- Ultrasound Basics

Those registered for the hands-on session with Bret Nelson and Victor Rao on Saturday, October 11 please view this primer prior to the workshop:Read more

2014 Emergency and Critical Care Ultrasound CME Course

The Mount Sinai Department of Emergency Medicine hosted its annual ultrasound CME conference on April 25. Faculty, fellows, nurses and PAs from a number of institutions and specialties took part in our tenth annual course. The course was directed by Bret Nelson, MD who introduced ultrasound physics and machine controls, followed by lectures on assessment of  airway and breathing (JimRead more