Look into my seeing EYE ball


    Look into my seeing EYE ball


    • Keep it basic…
      • APD
      • Intra-ocular Pressures: Tono-pen v Applanator (Goldmann)
      • Visual Acuity
    • or be a Slit Lamp KWEEN
      • Move outside in: Lids → Eyeball
      • Lids: ducts, eyelashes, orbital lesions or findings
      • EYE: Full EOM assessment and conjunctival assessment
        • Anterior:
          • Cornea for opacity, irregularities, fluericin staining for abrasions/ulcerations.
          • Anterior chamber assessment for “cell and flare” or hypopyon.
          • Lens for opacities.
          • Assess for extrusion of IOC contents.
        • Posterior: the dilated exam. Save that for your optho friends — but Ocular US for optic nerve measurements is a neat trick that we can do.
          • Visualize the posterior eye indirectly to assess for retinal detachment vs vitreous hemorrhage
          • Visualize & measure the optic nerve (3mm deep, with 5mm as your upper limit of normal)
      • Applanation for pressure (Goldmann is the GOLD standard…hehehe)
        • Here’s a quick readable how-to: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206330/
        • And these are youtube demonstrations:
          • https://www.youtube.com/watch?v=mS2HvAN4Uzg
          • https://www.youtube.com/watch?v=0b2Mv54mQcs (start at 07:48)
    • Welcome! This is the website for the Mount Sinai Emergency Ultrasound Division. It serves as an information resource for residents, fellows, medical students and others seeking information about point-of-care ultrasound. There is a lot ofRead more

    • renal handling of water

      If you were on a tea & toast diet, how much water would you need to drink before you develop hyponatremia? I haven’t seen anyone work out the numbers before so here are my calculations. AndRead more

    • acute acidemia physiology

      As alluded to in the first post, don’t be fooled by a “normal” potassium in the setting of DKA because osmotic diuresis and H+/K+ exchange means that total body potassium is actually LOW. You all knowRead more

    • renal handling of potassium

      the first symptom of hyperkalemia is death Earlier post covered temporizing measures to counter hyperkalemia — namely, intracellular shift, increasing cardiac myocyte threshold potential. Give furosemide if the patient still urinates and consider dialysis, but then askRead more

    • bicarbonate revisited

      Previous post reviewed the safety of balanced crystalloids in hyper K. But what was up with serum bicarbonate decreasing with saline administration? This post introduces a new way of looking at the anion gap to possiblyRead more

    • hyperkalemia and balanced crystalloids

      Is it safe to give LR or plasmalyte to a hyperkalemic patient (these balanced crystalloids have 4-5 mEq/L K as opposed to 0 mEq/L K in normal saline)? Postponing the discussion of renal handling of potassium toRead more

    • hyperkalemia physiology

      You’ll likely encounter hyperkalemia on your next Resus / Cardiac shift, and you’ll instinctively treat it. But take a moment to review the fascinating physiology behind the “cocktail”! First, consider how K+ is buffered byRead more

    • Slow down your tachycardia (but not really)

      You’re sitting in resus bemoaning the departure of your most beloved attending when suddenly a patient wheels in without warning. The patient looks relatively stable but the triage RN tells you her heart rate wasRead more

    • Otitis externa: use the ear wick!

      Acute otitis externa (AOE) is a common complaint seen in pediatric as well as adult emergency departments. AOE is typically not accompanied by acute otitis media, although concurrent cases are possible. Also called “swimmer’s ear”Read more