I can count the number of severe burns I’ve seen in residency on one hand. I suspect that’s true for many of us, especially if you don’t work at a burn center. The problem is that these patients can be really sick and requ…
Often in the ED we are faced with a patient who is on anticoagulation and needs an urgent procedure. Lumbar puncture is a very safe procedure overall, but it’s particularly dicey in the setting of anticoagulation because of the possib…
Today we bring you a compilation of several tips to make your next central line go more smoothly. Interns and 2nd years will probably find these tips most useful, but you’d be surprised how much you can pick up even as you get further…
There is no denying that if I were to suffer a sudden hemodynamic collapse and would wind up in an emergency department, I would want it to be one in which the emergency physicians were fully trained in POCUS (point of care ultrasound) and…
Chest pain: the bread and butter of emergency medicine. We see so many of these that it can be mind-numbing, and for EXACTLY that reason it’s critical to recognize those weird EKGs that aren’t an obvious STEMI but can signal a c…
Salicylate toxicity has a long history of causing morbidity and mortality in ED patients. Historically there has been a decline in the number of cases of salicylate poisoning due to concern regarding Reye’s syndrome. However, in recen…
A Trichobezoar A 45 year-old female with hx of anemia presents to your ER complaining of 2 days of abdominal pain with nausea and several episodes of dark emesis but otherwise conversant and non-toxic in appearance. She has not passed stoo…
Let’s say you’re seeing a 65-year old guy who is coming in for cough, and malaise. Plus, he was recently diagnosed with atrial fibrillation and started on coumadin, but hasn’t really been going to his appointments because…
The hardest part of intubating your sick patient shouldn’t be the gastric tube. That’s what med students are for, right? Unfortunately, NG or OG tubes can be frustratingly difficult to place. A couple researchers from anesthesia…
As ER docs, we see more EKGs per day than 95% of doctors out there. To survive, you have to be good at recognizing the big EKG findings, like STEMI, pericarditis, PE, and a multitude of arrhythmias. But if we’re honest, there’s…
Everyone loves a good intubation on an otherwise long and dreary resus shift. You’re at the head of the bed, totally boss, giving commands to your attending to ‘pass me the tube’, and it feels great when that cuff passes t…
Among the least commonly utilized intubation techniques stands the humble digital intubation. The name says it all: the intubator uses their index and middle finger like a miller blade to locate (by palpation) and lift the epiglottis before…
The thin, friable skin of elderly patients can present a special difficulty for laceration repair. If you find yourself pulling through the skin as you try tighten knots, applying steri-strips along the edge of the skin can serve as a forti…
When consulting your surgical colleagues about a potential small bowel obstruction, you may often be requested to place a nasogastric tube for bowel decompression regardless of how the patient appears clinically. Your patient will almost ce…
Although not a difficult procedure, the traditional approach to a digital nerve block involves two painful injections to the the digital nerves on either side of a finger, and may yield inconsistent results. An alternative, the flexor tendo…
