When you examine the ECG of a patient who syncopized, what are you looking for? You’re probably checking for a prolonged QT interval, signs of left ventricular hypertrophy consistent with hypertrophic obstructive cardiomyopathy, a delta wav…
To call opioid use in the US a “problem” is a gross understatement, and most of us in Emergency Medicine appreciate this. You may believe that if you only prescribe a small number of pills to an opioid-naïve patient who is truly in pain, yo…
*Thanks to Dr. Clark Owyang for following this “case” with me! On February 13, Kim Jong-un, son of Kim Jong-il and half-brother of current North Korean leader Kim Jong-un, was poisoned at Kuala Lumpur airport in Malaysia….
De Gans J, Van de Beek, D. Dexamethasone in adults with bacterial meningitis. New Engl J Med. 2002;347(20):1549-56. What we already know about the topic: Bacterial meningitis is a dangerous condition with significant associated morbi…
Methylene blue (MB) is a heterocyclic aromatic compound, and a basic thiazine dye. We all know that it is used to treat methemoglobinemia. MB is an oxidizing agent, which becomes a reducing agent when NADPH reduces it to leukomethylene blue…
Myxedema coma, or severe hypothyroidism, is an emergent condition with a high mortality rate (30-60%). Our patients rely on us to catch it early and treat aggressively. About 90% of cases occur during the winter months, and it is rarely see…
In October 2016, the Pulmonary Embolism in Syncope Italian Trial (PESIT) was published in the New England Journal of Medicine. Since its publication, it has generated a great deal of conversation and controversy. First, a brief rundo…
Weaver LK, Hopkins RO, Chan KJ, et al. Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med. 2002 Oct 3;347(14):1057-67. What we already know about the topic: Carbon monoxide poisoning is responsible for about 40,000 v…
When we call our colleagues from ENT with a question about a patient’s tracheostomy, they’ll want to know what type of tube the patient has. Let’s go over two types: Plastic Tubes Flexible plastic tubes (most common brand name is Shi…
What happens when a patient’s pacemaker seems to be malfunctioning? “Call the EP fellow” should not be your only answer! Take a look at the ECG, and ask yourself if the pacemaker may be over-sensing, under-sensing, or failing to capture….
“Trust, but verify” -Ronald Reagan Why would you need ultrasound for tube confirmation? You can confirm placement with direct visualization (sometimes video laryngoscopy), use end tidal CO2, look for color change on color…
“I quit school in the sixth grade because of pneumonia. Not because I had it, but because I couldn’t spell it.” – Rocky Graziano Article Citation: Bauer TT, Ewig S, Marre R, Suttorp N, Welte T; CAPNETZ Study Group. CRB-65 predi…
“If there’s a pill, then pharmaceutical companies will find a disease for it.” – Jeremy Laurance A recent study conducted at an urban health care center (Friedman et al. 2017) compared outcomes for diazepam in conjunction…
“The role of a clown and a physician are the same – it’s to elevate the possible and to relieve suffering.” -Patch Adams Do you regularly raise the head of the bed when you intubate? Well, maybe you should! A recen…
Don’t forget to consider Fitz-Hugh-Curtis Syndrome in your right upper quadrant pain differential! Fits-Hugh-Curtis Syndrome is a rare disease process characterized by perihepatitis as a complication of pelvic inflammatory dise…
