A 60 year-old male patient with a history of hypertension is BIBEMS with his spouse two hours of sudden onset memory loss. She noticed he began asking her if she wanted coffee every 3 or 4 minutes, apparently not remembering he had already…
by @benazan I have been surprised by the lack of pain in some patient with hip fracture. Most I have seen seem to be fine as long as the remain perfectly still. However, how often does that happen? After x-rays, multiple attending and resid…
by @BenAzan Over the last several months, the Mount Sinai Emergency Department has been implementing TeamSTEPPS to improve the workflow, communication and operations in the Emergency Department. What is TeamSTEPPS? It’s essenti…
By @BenAzan What pearl could I possibly find worthy of continuing tweets and dissemination? The last two posts, one of which was retweeted by both @M_Lin and @precordialthump (thanks!), are a tough act to follow. So first I thought about ma…
By @BenAzan Today’s post on Resus.me by @cliffreid was yet another reminder of how challenging (if not impossible) it is to predict a difficult airway. The study he quotes (1) looked at ~188000 intubations by anesthetists in Denmark….
As the year is coming to an end, a great place to look for inspiration for 2015 is Academic Life in Emergency Medicine’s series “How I work Smarter“. I’ve been reading these and wanted to share some highlights. The f…
A nurse hands you this EKG with a concerned look… She say it’s a 35 y/o man who is coming in for shortness of breath and palpitations since last night. The next question you ask is vitals? Yes! BP 96/57, HR 201 ,RR25, pO2 99 on…
Despite the fact that some at Sinai believe that social media is not essential for your education, others think it’s critically important. The concept is called FOAM for Free Open Access Medical education. You can read a full history…
You’re on your last patient of the day, starting to thinking about which type of sushi you’re going to order later, when the ultrasound comes back. Positive study, you were sure of it, after all, the patient had a hx of cancer a…
Question: -In acute stroke, does the addition of intra-arterial management improve outcomes compared to usual care? Methodes: -Multicenter, randomized, open-label (but blinded end points) in the Netherlands. 502 patients in 16 centers. -Co…
@JoePinero 50 yo M hx of NIDDM, recent left shoulder surgery x 4 mo ago for rotator cuff tear, currently presenting with left arm pain from shoulder to hand with swelling and tightness of the left hand and fingers. Exam: Well-appearing male…
@JoePinero Quick Case: 17 mo M child presenting with painless bright red rectal bleeding x 1 day. Benign physical exam. Afebrile, with stable vitals and normal labs. Dx: Meckels Diverticulum T99 scan for diagnosis (Sensitivity 85-97%, Speci…
@JoePinero Prisoners can often cause a lot of ethical dilemma’s when attempting to treat them in the hospital setting. Often times, physicians are reluctant to allow prisoners to sign-out AMA. However, there have been several supreme…
@JoePinero A 40 yo M hx of HTN, HLD, DM, PVD, who can’t turn left, is not Derek Zoolander, he’s a man having a stroke! KNOW YOUR STROKE SYNDROMES!!! As we know, this is a favorite topic of the boards, and will time and again be…
by @JoePinero The next time you have a patient with a dislocated jaw, hand them a 5cc or 10 cc syringe and tell them to stop, drop, bite and roll!
