Let’s keep on the suturing topic and talk technique! Interrupted suture– most commonly used in ED to close percutaneous wound Wound edges must be everted Needle enters skin @ 90 degrees with the suture loop as wide as it is deep to th…
Monofilament v. multifilament (braided or twisted) – Monofilament – stronger, low tissue drag and harbor less infection. But DO NOT handle as easily and multifilament Multifilament- handles easily but promotes tissue infection and rea…
78 yo f presents with generalized weakness. Patient denies any complaints per se and was brought in by family member after patient could not answer her door due to her weakness. Vital signs were stable. Physical exam was unremarkable and sh…
23 year old male with HIV presents with 1 week of fever, cough with yellow sputum, malaise presents with worsening of symptoms. Patient has vital signs of T103, P110, BP135/89, sat 90% on RA. Physical exam reveals coarse rhonchi bilaterally…
It has been a long, eventful week in the wake of the tragedies in Boston and to honor those who were affected by the attacks, I would like those who are able, to have a moment of silence at 2:50 PM. To those further interested, below is th…
Good morning! Please see above for a response to last week’s tragedy. 44 yo female presenting with nausea, vomiting and abdominal pain. Patient is a chronic alcoholic with no other drug use admitted. Patient is tachycardic to 1…
Oh bother *sigh* its Thursday April 11, 2013. Cloudy today 56 degrees with 30% chance of rain, going down to 44 degrees tonight with 60% chance of rain. Let’s try to brighten up our day with another wonderful pearl by y…
Summer!! I love summer!! Its a beautiful, gorgeous day in the big bad city! Beware the T-storms later tonight! Thanks to Dr. Elizabeth Weinstein from Indiana University School of Medicine for a riveting and wonderful lecture on potentially…
Vasopressors and Inotropes in the Critically Ill Patient RECEPTORS: Alpha-1 adrenergic receptors are located in vascular walls, induces significant vasoconstriction Beta-1 adrenergic receptors are most common in the heart and mediate ion…
Quick and Dirty- ESCHARTOMY Full-thickness skin burns result in the formation of a tough, inelastic mass of burnt tissue/eschar. By virtue of this inelasticity, there may be accumulation of fluid within the confined anatomic spaces u…
STATUS EPILEPTICUS Persistent seizure >5minutes or recurrent seizures without return to consciousness in 5 minutes Initial Treatment Lorazepam (preferred over diazepam because longer t1/2 of distribution in CNS): 2-4 mg IV every 1…
54F history of hypertension, diabetes, and ESRD presents to your Emergency Department hypotensive and febrile, nurses are hunting for IV access and unable to obtain any peripheral access, what can you do for access? Answer: Us…
Case courtesy of Dr. Jenny Sanders. 14F woke up this morning and collapsed due to leg weakness while on her way to the bathroom; is able to crawl but can’t walk; has some tingling in her LE. Was in usual state of health the day before. No s…
Thanks to Dr. Fleischman for this interesting case 62 year old woman with obesity, htn, hld, copd presents with sudden onset left upper quadrant pain, painful respiration. No f,n/v/d. Patient is noted to be in pain, tachycardic, norm…
18 y.o. male h/o asthma presenting with chest pain this AM. Pain was substernal, crushing with intermittent sharpness, and has been waxing and waning all day. CP is pleuritic, not positional. Also reports some malaise, decreased appetite, n…
