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Here is a pearl about nasal foreign bodies:   The nose is the MC site of fb insertion, seen mostly in children <5 years. Most of the time, the risk of aspiration and complications are low. However, if the fb is a button battery or a set of paired disc magnets, the risks can beRead more

You are at elmhurst in the cardiac room. It is FREEZING outside. The triage nurse tells you there is a frequent flier in triage, EMS found him sleeping on the street with +AOB. He is confused and moaning to sternal rub. They cannot get an oral temp and they cannot find the rectal probe, butRead more

So you’re in peds and your patient is anemic. You need to transfuse, but you are confused. How much blood do you give? How fast do you give it? How much: The volume of blood to be transfused may vary depending on the clinical scenario. The transfusion volume is usually 10 to 15 mL/kg. InfantsRead more

Your patient is a 24 yo M with chest pain.  It is pleuritic. He has normal vitals and you’re not too concerned. You get a CXR and you see the result in this post. He has pneumomediastinum! What is that? What do I Do now? Spontaneous pneumomediastinum is rare, occurring in approximately 1 in 30,000Read more

You are on a flight, halfway across the Atlantic Ocean at the start of a much needed vacation, binge watching that new show everyone has been talking about but you’ve never had time to see.  Suddenly, the screen freezes and an overhead announcement interrupts your zen-like, screen-induced partial stupor.  “Is there a doctor on board?”Read more

  Your patient with a newly diagnosed PE hates hospitals.  He or she agrees to defer to your judgement about admission versus discharge home, but makes it clear they would prefer to go home if it is safe.  Which tool should you use to help you decide? Up until recently, there were no prospective studiesRead more

We give out canes like they’re candy.  But are we doing a good job adjusting the cane and teaching patients how to use them?  Canes that are not the right height for your patient or are being used incorrectly can put patients at an even greater risk of falls.   The proper height can beRead more

A patient comes to the emergency department reporting a few days of excruciating pain in a band around his right chest.  Today, he developed vesicles over the same area which prompted him to come in.  Classic shingles.  Like most patients diagnosed with this disease, he is sent home with wound care, return precautions, contact precautions,Read more

  You are the leader of the code team.  Your patient is in refractory VF after multiple rounds of shocks and drugs.  You’ve tried repositioning the pads into an anterior-posterior position.  Looking around, you ask for suggestions.  Someone suggests double sequence defibrillation.  After all, what’s the harm?   Sorry to take away one of yourRead more

  It’s 1 am and things are winding down.  The trickle of patients has slowed and it actually looks like you and your team are catching up.  Suddenly, you hear yelling, swearing and crashes coming from triage.  Other patients are looking around to see what is going on.  The sound of the triage nurse comesRead more