On Not Crackin Dat Chest

This Sept 2015 Annals of Surgery article made a splash when it first came out a year ago, and it came up again yesterday in conference. Here’s a refresher. FAST ultrasound examination as a predictor of outcomes after resuscitative tho…

Tap dat obese belly

We do a lot of diagnostic taps at our shop. People need to take better care of their livers. Here’s a tip for your next tap. I recently encountered a very obese cirrhotic patient who required a diagnostic tap. He had several very deep…

(De) Winter is coming

  A middle-aged man presented to the ED with chest pain for the past 2 hours. This is his EKG. What’s your next move?       If you look at the anterior leads, you’ll notice upsloping ST depressions and tall,…

Dosing that Special K for pain

The traditional dosing range of ketamine for analgesia is 0.1-0.6mg/kg IV.  It’s funny to use the word traditional because ketamine is still not completely universally considered an option for analgesia, despite its increasingly wider…

Broselow to the Rescue!

How do you calculate the correct ETT size for a child in a pediatric resuscitation? ETT size = (age + 16) / 4 ETT size = (age/4) + 4 ETT size = 4 + 1/4 age If you find yourself thinking about the order of operations (PEMDAS for anyone who m…

Diastology

It’s not just about the squeeze. You gotta think about the filling. Yes, today we’re talking about diastology (I didn’t make that word up) AKA diastolic heart failure AKA heart failure with preserved ejection fraction AKA…

Baby Hearts and Flipped T Waves

  Take a look at the above EKG. If you saw this in a 70 year old patient with chest pain, you might be a bit concerned. Tachycardic, inverted T waves anteriorly, a partial RBBB in V1. Are these ischemic changes going on? Where is this…

September 2022
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