It’s not just about the squeeze. You gotta think about the filling. Yes, today we’re talking about diastology (I didn’t make that word up) AKA diastolic heart failure AKA heart failure with preserved ejection fraction AKA…
Steri-strip and Suture Combo Technique for Repairing Fragile Skin Old people. They come with all sorts of problems and complications. Even simple lacerations are more complicated with them. Have you ever encountered a laceration in…
All the hard parts are done in the placement of your central line. You nicked the vein and NOT the artery. The wire threaded smoothly. You got confirmation on your ultrasound. Now, you just insert the triple lumen in over the wire. Insertin…
Inspired by Dr. Schuberg’s outstanding procedural skillz this week, I present the thoracentesis: Indications: Suspected pleural space infection, new effusion without diagnosis, and relief of dyspnea caused by large effusion Contraindication…
Before answering that question, I need to acknowledge EM topics (http://www.emtopics.com/article-a-day/2016/discharge-glucose-level-is-not-associated-with-return-to-ed) for bringing this important article to my attention since this is nearl…
We are all too familiar with tachypnic and the occasional bradypnic patient (i.e. narcan deficient) rolling through resus, but rarely do we come across platypnic and orthodeoxic (except for yesterday). In order to come across them, you need…
Intubating a patient with a suspected head bleed is one of the highest risk situations we encounter as ED physicians. A failed attempt with enough airway manipulation can potentially increase ICP and have profound negative effects on patien…
A 24yo M with hx schizophrenia presents to the ED agitated, threatening staff and making gestures of self-harm. You are unable to verbally deescalate him and go to order some sedative medication. However, on his chart you see “Allergy: ha…
This week’s pearls is a series on “Name that Poisonous Beast!”. So, let’s start. Name this poisonous beast: A) And its 8-legged colleague: B)
Do central line-associated bloodstream infection (CLABSI) rates differ based on whether they were placed in the ED versus the ICU? A recent article published in Academic Emergency Medicine attempted to answer this very question. Central lin…
aVR is the neglected cousin of the other ECG leads. He doesn’t always make sense, nobody really understands him, and he usually sits alone at the dinner table. This is to the detriment of those who ignore him, as aVR can easily lead clinici…
Today’s pearl is short and sweet. Here’s a breakdown of common radiologic studies performed in the emergency department along with their sensitivities and specificities according to the available literature. You may be surprised by so…
What do you do if your septic patient now has a lactate of 12 and a pH of 7.00? You’ve already started your fluids, antibiotics, pressors, and have ruled out any unaddressed source. Intuitively, your patient’s acidosis should be corrected b…
Although clinical practice may differ, vagal maneuvers are still the first step in attempting to convert supraventricular tachycardia (SVT) to sinus rhythm prior to adenosine. The reason why they are rarely attempted is because of relativel…
Your patient with respiratory failure was successfully intubated and admitted to the MICU. Two weeks later he comes back to the ED complaining of persistent hoarse voice and dysphagia. He states he was extubated 1 week prior and was told hi…
