At our wellness conference we talked about different strategies to manage burnout through gratitude, deep breathing exercises and story-telling. Today we will add another technique to our wellness arsenal: spending time in nature. In NYC, this may be difficult, but luckily we have multiple parks and green spaces throughout our city and Central Park isRead more

52 in 52: Nasogastric tube in GI bleeds

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 we already know about the topic: Nasogastric aspiration and lavage for patients with melena or hematochezia to localize GI bleed is controversial. Supporters argue thatRead more

Ouch! My thumb!

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 known as skier’s thumb. The mechanism is aRead more

Emergency Cricothyrotomy: A Review

We do a lot of life-saving procedures and interventions on a daily basis in the emergency room. However, there are some much less frequent but equally as important life-saving procedures we need to know how to do. Today we will review how to do an emergency cricothyrotomy. This procedure is indicated for those patients youRead more

Conjunctivitis In A Newborn

A mother brings her 4 day old newborn baby boy into the Peds ED for bilateral eye discharge. Mom tells you he was full-term and healthy, but she did not have prenatal care. The baby is well appearing and is eating, urinating and defecating well. A picture of his eyes are above, are you concerned? YouRead more

52 in 52: CRASH-2 Trial

Article Citation: CRASH-2 trial collaborators, Shakur H, Roberts I, Bautista R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3;376(9734):23-32. PMID: 20554319 What we already know about the topic: Traumatic injuries are a major cause of deathRead more

The Syringe Technique for TMJ Dislocations

Acute non-traumatic temporomandibular joint (TMJ) dislocations occur after extreme opening of the mouth (yawning, eating, laughing, singing or dental treatment. TMJ dislocation is when the anterior condyle moves too anteriorly and becomes locked in the eminence. This also results in stretching of ligaments and is associated with severe spasm that results in difficulty closing the mouthRead more

The NYC Marathon and Heat Related Illnesses

The NYC Marathon is this Sunday! The city has been gifted with some unseasonably warm weather the past couple days, but this has the potential to cause problems for the thousands of runners. Today we will talk about heat exhaustion and stroke, which represents the most severe end of a spectrum of heat related illnesses.Read more

Dermatologic Emergencies

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 the picture below what should you be worried about? Stevens-Johnson syndrome (SJS) and toxic epidermalRead more

52 in 52: Ottawa Ankle Rules

Article Citation Stiell IG, Greenberg GH, McKnight RD, Nair RC, et al. Decision rules for the use of radiography in acute ankle injuries. Refinement and prospective validation. JAMA. 1993 Mar 3;269(9):1127-32. PMID 8433468 What we already know about the topic: Patients presenting with ankle injuries is a common occurrence in the emergency department, but less than 15%Read more