We’ve all seen the patients roll in with EMS nasal cannula snug against their nares. “Why are they on oxygen?” EMS response, “I don’t know he was having chest pain.” EKG shows STEMI! The last thing you…
Seeing our alumni at ACEP was amazing! It seems like Life after Residency is sweet: making your own schedule, working with great colleagues, no more pushing people to CT, developing startups! The sky is the limit but then there’s the…
Overdose and EKGs they start to all look the same…widened QRS, that thing in aVR…vfib (hopefully not). Here’s a highlight of key EKG findings associated with a few toxidromes: (1) Bupropion overdose (2) TCA overdose (3) Di…
Dr. David Forsh’s review yesterday of compartment syndrome made me realize how rarely we see this life-threatening diagnosis. So what do we need to know? What’s the etiology of compartment syndrome? Majority cases 2/2 Fractures…
Chest pain…everyone gets it…sometimes when a patient says they have chest pain I get chest pain. What’s the solution to this chest pain epidemic? Troponins! Well not so fast because they aren’t fast…especially…
Have you ever had those patients that are agitated? In a Zombie-like frenzy they rip out all their lines and extubate themselves in the CT scanner agitated? I think we’ve all been there (hopefully with something for sedation in hand!)…
So you’ve I&D’d that abscess, there’s no surrounding cellulitis you’re ready to Treat em’ and Street em’ but the patient asks: “Can I have some antibiotics, please? And maybe a sandwich?”…
Left Bundle Branch Blocks (LBBBs) are scary because they can be confused for MIs and MIs are scary…almost as scary as Y2K. Which takes us back to the 90s…the good days, good music, great hairstyles, and Sgarbossa! 20 years ago w…
Bedside sono for DVT: Ready for primetime? You got a patient with an enlarged, red, angry leg. It screams sono me for DVT! It is midnight and radiology tells you it cannot be done until the morning. Can YOU sono the patient? Technically yes…
What do all these EKGs have in common? They are all hyperkalemia! How hyperK+ are they? Turns out it is probably hard to say…there’s a Basic Rubric: P…
SBO you say? 6-infinity hours until dispo?! Sometimes it feels like you want to just rub a lamp and all your dispo decisions would be granted! Maybe it can!? Enter SBO and ultrasound! What are you looking for on US? (Westafer & Faust 20…
Chest tubes hurt…I imagine. And the few times I’ve done them (x2) I’ve wondered couldn’t that person have just gotten a pigtail?! What does the literature say? Voisin et al 2014 asked if large pneumothoraces (>2-3…
This case was brought to my attention by the wonderful Sam Schuberg. Impressively he drained a large pleural effusion in the ED offering his patient “Upstairs Care Downstairs”. He then brought to my attention that when dr…
First thing that probably comes to mind when you hear peripheral vasopressors is “when is this patient getting a central line (CVC)?” or “COWBOYS!” because as ED docs that is what we are and how else to express that…
The Stats: 350,000 out-of hospital cardiac arrests (OHCA)/209,000 in hospital cardiac arrests (IHCA) each year (2016) Majority of cases have a primary cardiac etiology with vfib as presenting rhythm So SHOCK IT!…..Surviv…
