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…
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…
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…
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…
Article Citation: Karounis H, Gouin S, Eisman H, Chalut D, et al. A randomized, controlled trial comparing long-term cosmetic outcomes of traumatic pediatric lacerations repaired with absorbable plain gut versus nonabsorbable nylon sutures….
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…
Article Citation: Kocher MS, Mandiga R, Zurakowski D, Barnewolt C, Kasser JR. Validation of a clinical prediction rule for the differentiation between septic arthritis and transient synovitis of the hip in children. J Bone Joint Surg Am. 20…
Title: “The 52 in 52 Review: PE Rule Out with Wells and D-dimer” Article Citation: Wells PS, Anderson DR, Rodger M, Stiell I, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: Management of patients with suspect…
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…
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…
Background: Acute aortic syndromes (AAS) include aortic dissection, intramural aortic hematoma, penetrating aortic ulcer and aortic rupture. AAS are rare but life threatening cardiovascular emergencies with non-specific clinical presentatio…
4 Reduction Techniques of Anterior Mandible Dislocation Classic intra-oral reduction Place thumbs over the patient’s inferior molars Apply downward force and then guide the mandible posteriorly Wrist Pivot Method Place thumbs at the chin P…
Clinical Scenario: 28 yo F with unknown medical history presents with multiple seizures. Routine BMP shows hyponatremia to 110. What is your next step for symptomatic hyponatremia? Causes of hyponatremia: Hypervolemic Hyponatremia: congesti…
