Blog

Slow down your tachycardia (but not really)

You’re sitting in resus bemoaning the departure of your most beloved attending when suddenly a patient wheels in without warning. The patient looks relatively stable but the triage RN tells you her heart rate was in the 150s — no time for a full set of vitals or an EKG. You adeptly obtain these; theRead more

Otitis externa: use the ear wick!

Acute otitis externa (AOE) is a common complaint seen in pediatric as well as adult emergency departments. AOE is typically not accompanied by acute otitis media, although concurrent cases are possible. Also called “swimmer’s ear” due to the increased likelihood of developing after prolonged submersion in water, AOE can be caused by trauma, foreign bodiesRead more

Reach for the COWS

Your patient in intake is miserable. Doubled over, complaining of pain everywhere, sweating, ill-appearing but not unstable. He tells you that the last time he used heroin was two nights ago, and he is asking for help. How do you treat this patient? And how do you determine what medication would be appropriate? There areRead more

Tis the season, summer edition

As the late spring rains have begun to fade and the temperature rises mercilessly into the 80s and beyond, summer is finally upon us. And with summer comes a host of diseases for the emergency physician to consider. Heat stroke, mosquito- and tick-borne illnesses, chicken pox, an expanding measles outbreak…and a less threatening cause ofRead more

Meet the newest member of your team

We have a new resource in the Sinai ED. Say hello to your friendly ED pharmacist. In the past several years, the ED pharmacy has been centralized in a non-ED location. We all know well these faceless interactions with a human reminding you to renally dose your Zosyn, stop ordering the bicarb drip that way…andRead more

E-point Septal Separation in the Patient with Congestive Heart Failure

Perhaps never explained so clearly, Cisewki and Alerhand’s article on EPSS is a wonderful read. Bottom line to remember: EPSS > 7 mm was 87% sensitive and 75% specific at identifying reduced EF (<50%).  This is the cutoff generally used to point to an abnormal EF (but isn’t it all about stroke volume, really?)Read more

Lidocaine for cough?

Whether it’s asthma, a U.R.I., or post nasal drip as the cause, cough is a common enough complaint encountered by emergency physicians everywhere. Of course you must always rule out the dangerous causes of cough (PNA, Measles, PE, Heart failure, CHF, lung cancer PVCs ) but once thats done, you still have to treat theRead more

The Apple Watch Heart Study

Disclosure: I’m a huge Apple Fan. Unless you’ve been living under a rock, you’ve heard about the Apple watch, many of you reading this are wearing one right now. On April 24th, 2015 it joined a long list of wearable wrist devices that can monitor things like steps, energy expenditure, and even heart rate (1).Read more

Peritonsillar Abscess I&D…Can you ditch the endocavitary probe?

Today’s post is inspired by real-life events and comes with a video (consent given by the patient and providers). The case: 29M presents with dysphonia, odynophagia, and drooling. He is hypertensive, with a low-grade fever, but he is maintaining his airway and has a good respiratory rate/o2 saturation. Examination of the posterior oropharynx shows aRead more

Amanita Muscaria

For those of you who remember Super Mario Bros… how awesome was it to gobble up that red and white mushroom gliding along the ground and get huge for a few seconds? The result of consuming this mushroom was a bigger and badder Super Mario who was ready to break bricks and take names. However, the color andRead more