For our clinical pearl today I thought I thought I would do some basic ECG teaching. This is a real case that I saw with Carlo at Elmhurst in the cardiac room. As always, we will start with a clinical scenario. A middle-aged male with unkno…
The Interscalene Block So, you want to provide local anesthesia to the patient with a broken clavicle or a dislocated shoulder. Maybe there’s a proximal / mid-humeral fracture or an injury over the deltoid. Whatever your needs may be,…
Today’s lower extremity block is going to be the posterior tibial nerve. The sensory distribution should be helpful for things like foreign bodies that need to be taken out of the foot. Anatomy – The largest of the five…
Article Citation: Palamidessi N, Sinert R, Falzon L, Zehtabchi S. Nasogastric aspiration and lavage in emergency department patients with hematochezia or melena without hematemesis. Acad Emerg Med. 2010 Feb;17(2):126-32. PMID: 20370741 What…
A 44M with no PMH slipped and fell on his hand while playing with his kids in the park. He has swelling and pain over thumb MCP joint that is exacerbated by movement. The xray of his thumb is above, what is your diagnosis? This injury is kn…
Case: 40 year old male presenting with rash for one day. Patient recently started Bactrim, endorsing flu-like symptoms for the past 2 days. Chest and back are erythematous and warm. In the ED, patient is febrile and tachycardic. Based on th…
Seeing our alumni at ACEP was amazing! It seems like Life after Residency is sweet: making your own schedule, working with great colleagues, no more pushing people to CT, developing startups! The sky is the limit but then there’s the…
Overdose and EKGs they start to all look the same…widened QRS, that thing in aVR…vfib (hopefully not). Here’s a highlight of key EKG findings associated with a few toxidromes: (1) Bupropion overdose (2) TCA overdose (3) Di…
Dr. David Forsh’s review yesterday of compartment syndrome made me realize how rarely we see this life-threatening diagnosis. So what do we need to know? What’s the etiology of compartment syndrome? Majority cases 2/2 Fractures…
Chest pain…everyone gets it…sometimes when a patient says they have chest pain I get chest pain. What’s the solution to this chest pain epidemic? Troponins! Well not so fast because they aren’t fast…especially…
Have you ever had those patients that are agitated? In a Zombie-like frenzy they rip out all their lines and extubate themselves in the CT scanner agitated? I think we’ve all been there (hopefully with something for sedation in hand!)…
So you’ve I&D’d that abscess, there’s no surrounding cellulitis you’re ready to Treat em’ and Street em’ but the patient asks: “Can I have some antibiotics, please? And maybe a sandwich?”…
Left Bundle Branch Blocks (LBBBs) are scary because they can be confused for MIs and MIs are scary…almost as scary as Y2K. Which takes us back to the 90s…the good days, good music, great hairstyles, and Sgarbossa! 20 years ago w…
Bedside sono for DVT: Ready for primetime? You got a patient with an enlarged, red, angry leg. It screams sono me for DVT! It is midnight and radiology tells you it cannot be done until the morning. Can YOU sono the patient? Technically yes…
Chest tubes hurt…I imagine. And the few times I’ve done them (x2) I’ve wondered couldn’t that person have just gotten a pigtail?! What does the literature say? Voisin et al 2014 asked if large pneumothoraces (>2-3…
