Expressing Empathy in the ED

Have you spent the past week wondering how you could express empathy more successfully? Don’t re-invent the wheel, use a tool from palliative care — NURSE statements! Name the emotion: “Many people would feel angry if that happe…

What to do with a metabolic kid

Ornithine transcarbamylase deficiency, citrullinemia, methylmalonic acidemia, tyrosinemia, phenylketonuria, Galactosemia… did I lose you yet? These words bring me back to the dark place of step one studying. So take a deep breath, don’t wor…

Naloxone — a how to

Have you ever tried to figure out what the appropriate starting dose of naloxone is? When you dig in the literature it’s pretty clear that its a lot of hand waving and muddy water — but let me give you an approach and some of th…

Know about NO?

Consider inhaled nitric oxide in massive PE and watch for upcoming literature. Massive PE elevates pulmonary vascular resistance leading to right ventricular failure, hypoxemia, and cardiogenic shock. Inhaled nitric oxide selectively dilate…

Take Pride in the Para

Ever been annoyed when you try to admit a liver patient and the MAR requests that you perform a diagnostic tap prior to admission? Here is the data behind why we perform diagnostic paracentesis in the ED. Bottom line: performing diagnostic…

Doubt Aortic Dissection?

Don’t want to read more? Here is the summary: There are a bunch of studies coming out looking at risk stratification for Aortic Dissection (AD). On chest pain patients check for focal sensory/motor neurologic deficit, pulse deficit an…

An Ode to the IO

The intraosseous line. What a beautiful solution to so many problems. Let’s take a minute to reflect on the IO, what it can do, how to do it, and to assuage your fears of complications. When to use an IO: If you think, “should we put in an…

The other ACS

You are in RESUS feeling like a boss (either it’s your last RESUS shift because you’re becoming a senior, you have finally made i through 2nd year and have learned how to tell Gueldye “no”, or are finally reaching the end of end…

Chronic Back Pain

You’re working overnight when your 10th patient comes in complaining of chronic back pain. You order acetaminophen and an NSAID but the patient refuses to take them. They’re upset, agitated and demanding their usual percocet as…

May 2018
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