Penicillin Allergy and Superbugs

  Penicillin allergy is a common finding in many patient charts.  Sometimes it can be difficult to figure out who, when and why this label was added to a medical record.  Sometimes patients themselves perpetuate the label, unwittingly…

Probiotics. Use them. Love them.

We all prescribe antibiotics frequently.  While the debate about who is contributing more to the terrifying antibiotic resistance patterns and the emergence of superbugs rages on, we can sometimes forget or minimize the fact that antibiotic…

Santa is Real. Here’s Proof.

Just kidding.  Happy Holidays, kids.   Follow Santa on his magical trek around the world: https://santatracker.google.com/village.html   Bonus: Want to know more about the Dreidel? https://www.chabad.org/holidays/chanukah/article_…

Concussion Recovery in Children

An otherwise healthy 11 year old boy is brought to the ED by his parent after “hitting his head pretty hard” during hockey practice.  The child was “out of it” for a little while but did not lose consciousness.  He seems foggy, complains of…

Doc, what if my head explodes?

It’s a busy Monday afternoon.  Patients are packed into the department like sardines.  You have bruises on your shins from trying to wade through the stretchers to discharge a few people, but now you’re back at the computer ready to pick up…

Zombie foot in need of repair

Imagine your patient is minding his or her own business when their foot gets crushed by a bus.  This totally hypothetical occurrence is only one of an infinite number of examples of situations that could result in a complex wound(s) needing…

Line ’em up like a boss

Patients in need of need central lines can often have less than ideal IVC diameters, either because of their disease process or because of their baseline anatomy.  Optimizing your chances of success through positioning can make a real diffe…

Does roc rock and suc suck?

A study just published this month in Annals of Emergency Medicine compared the 2 most common paralytics we use in the ED for RSI, rocuronium and succinylcholine. The primary outcome studied was first pass success rate, and the secondary out…

Opioid Conversions

Shoutout to RTO for this tidbit he learned from palliative care on a quicker way to do opioid conversions. Thought I’d share it with you all! Have you had patients who are on opiates at home, need pain relief, not exactly sure how muc…

Acute Flaccid Myelitis

We’ve gotten an email or two telling us to look out for Acute Flaccid Myelitis (AFM). What is it? Why does it matter? AFM causes flaccid weakness to one or more limbs rapidly in a polio-like neurologic fashion. There can also be crani…

To bicarb or not to bicarb

When, if ever, should we be giving bicarbonate in patients with metabolic acidosis? A study published in The Lancet in July 2018 involved a multicentre RCT in 26 ICUs with 400 patients, called the BICAR-ICU trial. It found that in severe ac…

PTSD in EM Residents

Winter is here. It’s colder. Sometimes we don’t see the sun for days. Let’s take a moment to think about some mental health issues. Published in Annals of Emergency Medicine in December 2017 was a piece by some of our very…

Foot vs Bus

In a totally hypothetical situation, imagine a resident’s foot got run over by a bus and looked like this after arriving in your ED… What sort of things should you be concerned about in injuries like this of extremities? 1. Vasc…

December 2018
M T W T F S S
 12
3456789
10111213141516
17181920212223
24252627282930
31  

Archives