Let’s Talk About Bicarb

If you’re like me, when you treat hyperkalemia, you make things easy on yourself and open up that HyperK orderset, or think about the mnemonic C BIG K DROP (Calcium, beta-agonist/bicarb, insulin, glucose, Kayexalate (Lokelma actually)…

Burn Management

Trauma Survey: Burns are trauma, treat these pts as such. Don’t let yourself get distracted by the obvious superficial injuries/wounds and be sure to go down your algorithm so you don’t miss anything. PRIMARY: Airway: Look for signs of acti…

Dripping in that Sedation

Today’s pearl: SEDATION DRIPS Titrating the sedation regimen on the sickest of patients can be one of the most challenging parts of the MICU. Anecdotally, many COVID+ vented patients in particular need at least 2, sometimes 3 diff…

Calcium Channel Overdose

For those who could not make it to VMR, we went over a truly sick calcium channel blocker overdose case. If not, here’s a quick rundown, and a link to the slides.   Briefly, the case was a 17-year-old female who reportedly overdosed on 60 m…

MRI Basics

As the stellar EM provider that you are, you’ve probably gotten pretty great at independently reading CTs, XRs, and even formal ultrasounds at this point. But what about the mysterious MRI? You know your consults need them, the radiologist…

A can’t miss head CT finding

For today’s TR pearl, I’d like to take you back to January 2020, when covid was just a foreign virus and I was a fresh-faced intern, shadowing one of our recent grads, Dr. Sengupta in the cardiac room, along with Dr. Meyers. EMS…

To send home or not – AC in nephrotic syndrome

This deep dive came from a question posed during a morning report by Jackson. Jackson presented the case of a patient presenting with a swollen penis at MSBI, found to have low albumin and diagnosed with nephrotic syndrome. These patients a…

Blood on the Dance Floor

We’ve all seen that movie where some old person coughs into a handkerchief and as the camera slowly pans away, there’s some blood stain. You know that guy isn’t making it to the end of the movie… Today, let’s t…

What with all these eyes?

As it may become very apparent, I take a lot of photos of interesting eye pathology. So what do you think is going on here? What if I told you that this had been going on for the past few days and they had been using steroid drops…

Visual Diagnosis

What do you think is going on here? So if you were the resident who signed up for this patient what would you do? As may be obvious, this is herpes zoster ophthalmicus, which is a reactivation of the VZV in cranial nerve V ophthalmic divisi…

GI Decontamination

Case: 37-year-old M presenting with obtundation and possible seizure-like activity after a large overdose of sustained-release bupropion (Wellbutrin XL), gabapentin, and other unknown medications. Given the severity of this patient’s…

Shoulder Reductions

So today, we’re gonna talk about shoulder dislocations. This should resonate with a lot of you residents considering the weather conditions currently, or if you were worried about what would happen if a certain SuperBowl performer wer…