Flomax for Ureteral Stones?

Using Flomax for ureteral stones has been a controversial topic. A meta-analysis of 8 randomized controlled trials consisted of 1,384 patients showed that there was no benefit in giving Flomax to those with ureteral stones < 5mm. However…

Intranasal Fentanyl

Delivering adequate analgesia in pediatric patients in a timely fashion is difficult. IV route requires staffing and produces additional pain and anxiety in this population. However, the oral route has a delayed onset. The benefit to IN fen…

Etomidate vs. Ketamine

Both etomidate and ketamine are commonly used as the induction agent for RSI in adult trauma patients. There are concerns about etomidate-associated adrenal suppression leading to complications in critically ill patients. This is a retrospe…

Epistaxis

The current treatment for epistaxis consists of holding pressure, local vasoconstrictor, silver nitrate or anterior nasal packing. Recently, the use of topical TXA has been purposed. A previous study in 2013 showed that topical TXA resulted…

Albumin in SBP?

We have many patients coming to our ED with cirrhotic liver disease with ascites. Up to 25% of patients with ascites have SBP. Once SBP has been identified, we use a third-generation cephalosporin to treat the patient. However, the benefit…

Modified Valsava for SVT

Background: SVTs are commonly seen in the ED. Chemical cardioversion often takes several minutes to initiate because we have to get IV access and medication ready.  During this time, we can attempt some valsava maneuvers to cardiovert stabl…

BiPAP

What’s the difference between BiPAP vs. CPAP? CPAP stands for continuous positive airway pressure. In other words, there is a continuous pressure regardless whether the patient is breathing in or out. CPAP only has one pressure setting. BiP…

June 2022
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