An Old but Still Ongoing Arguement

Asking an anesthesiologist or EM doc their choice of paralytic can spark heated debate.  What do you prefer? Succinylcholine: -depolarizing agent -30-60 sec onset -8-15 min duration -adverse reactions: bradycardia, hyperK, fasciculations, malignant hyperthermia, increased intracranial pressure -contraindications: herperK, burns or crush injuries, upper motor neuron disorders Rocuronium: -non-depolarizing agent -At 1.2 mg/kg; no differenceRead more

Blow by Oxygen

You’re rotating in the RICU and while there one of your patients develops respiratory distress requiring intubation. As you are preparing your equipment you notice that the intern on the team, who is trying to be helpful, is holding the BVM above the patients face to provide, “blow by oxygen.” Why is this not aRead more

Tylenol for Low Back Pain: No Better Than Placebo

This recent meta-analysis in the BMJ found that paracetamol (acetaminophen) was no better than placebo for the treatment of low back pain.  Read more

Peek Through the Orbit

32 yo overweight female presents with a headache.  This headache is similar to prior headaches, which she gets frequently.  The rest of her story seems consistent with a migraine and her physical exam, including a through neuro exam, is normal.  However, you still feel concerned because she’s in the right demographic for idiopathic intracranial hypertension.Read more