Abdominal Pressure Measurement

Abdominal compartment syndrome (ACS) is a condition in which the internal pressure of the abdomen becomes so great that it compromises venous return (and therefore hypotension), organ perfusion, and adequate ventilation.

Doc, I’m Feeling Lightheaded…

A 43-year-old patient arrives to the ED complaining of palpitations. Vitals are HR 298, BP 107/74, SpO2 100% RA, RR 18. The patient is diaphoretic, uncomfortable appearing, and heart sounds are fast and irregular. You obtain an EKG which sh…

Accuracy of Bedside Dvt Study

The two-point compression ultrasound exam assesses the lower extremity venous system at two points: common femoral vein and popliteal vein. Signs of DVT include lack of compressibility and visualized thrombus. [1]

Pocus Ruq

A 40 y/o G10P10 presents with RUQ pain worse with fatty foods. When evaluating for acute cholecystitis, what 5 sonographic findings do you look for? What is the Mickey Mouse sign? What is the mantle clock sign?

R-u-s-h

An 80-year-old male is brought by family for AMS. On initial assessment: BP 86/45, HR 160s, in AFib, tachypneic. While addressing the ABCs, you’re also wondering what diagnostics can be performed immediately to help evaluate this undifferen…

Mtp Pearls

32M BIBEMS s/p SW to abdomen. He becomes hypotensive/tachycardic, becomes less responsive. Massive transfusion protocol is initiated. What electrolyte abnormality is caused by massive transfusion? In the 1:1:1 ratio, are we talking about a…

Assessing Fluid Responsiveness

You are evaluating a 65yo male with PMH CHF presents with severe sepsis. You’d like to administer IV crystalloids but you’re not sure how much should be given. What are some tools to assess for fluid responsiveness?

A Lit Review: Age-adjusted D-dimer

A recently published retrospective study in the Annals of EM supports the use of an age-adjusted d-dimer cutoff when evaluating patients with possible PE. Standard cutoff = 500 ng/dL; Age-adjusted cutoff = patient’s age x 10 Click for more…

Got Propofol?

You are setting up for procedural sedation and would like to use propofol. What allergies should you ask of first? (Besides prior propofol allergy) [1]

Alumni Follow-up with Dr. Nelson Wong

Dr. Nelson Wong, 2013 grad of the Sinai EM residency, then chief academic resident, came back to his home turf to give a great session on chest pain, with many bonus pearls and concepts about how we learn. What has Dr. Nelson been up to in…

At Least the Pad Thai Was Tasty…

[1] Your fellow resident just returned from a long lunch break, raving about how good his meal was. He doesn’t seem to notice, but his breathing is labored and his face and arms are covered in an urticarial rash. What is the most likely con…

Cluing in to Opioid Overdose…

Case: 32-year-old male brought in by EMS for altered mental status, breathing six breaths per minute. You suspect opioid overdose, what clues you in to the culprit? 1) ECG shows prolonged QTC –> 2) ECG shows widened QRS –>…

September 2015
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