I know that documenting feels like the bane of our existence most of the time, but it is one of the most important things that we do, for a variety of reasons. The following pearl is going to go through aspects of documentation that I believe are important for residents to know. Side note, I by no […]
Ultrasound during cardiac arrest has quickly become standard. Initially, data suggested that the use of ultrasound during arrest increased pauses between compressions which worsens outcomes. To decrease time between compressions, many protocols were proposed (see here). One such protocol that successfully decreased time between compressions is the CASA (Cardiac Arrest Sonographic Assessment) protocol. The CASA protocol assesses for cardiac tamponade, right heart strain, […]
Today we’ll be discussing acute kidney injury (AKI). How often are you looking at the Bun/Cr thinking ‘Patient has an AKI’…and then not much more? I’ve done this. While ascertaining the underlying etiology is not always necessary in the ED, understanding AKI management, principles, and follow-up are important given the increased risk for progression to CKD and increased mortality (This […]
There are almost 1,000,000 pulmonary embolisms per year. Do all of them need to be admitted? From a dispo standpoint, it can be easier when you’re at larger academic centers to admit or obs them all but the reality is that some of them can be discharged! First off, this is attending-dependent. The idea of discharging PE’s […]
Insulins and DKA came up in conference last week, but we didn’t discuss the use of subcutaneous insulin in DKA. SQ insulin is a potential alternative to IV therapy in mild to moderate DKA, and I think there is still a lot of variability in provider familiarity and comfort with this treatment approach. Why use […]
Review of definitions – Migrant – a person who moves from one place to another – Refugee – a person fleeing persecution or fear of persecution on one of 5 protected grounds. – Asylum seeker – a refugee seeking protection from within the United States – 5 protected grounds: race, nationality, religion, political opinion, social group not protected: climate disasters, civil wars, poverty […]
1. New Zealand – The “Beveridge” Model Other countries: UK, Cuba, Spain How it works: Healthcare is provided and financed by the government. The government owns hospitals and clinics and doctors may either be hired by the government or privately but are paid by the government. Benefits: Universal coverage, lower cost of healthcare, fewer disparities Drawbacks: Long wait times, limited available […]
Applying the LUCASwith minimal pauses in chest compressions FIRST STEP: LUCAS backboard behind patient’s head SECOND STEP: lift patient forward to slide backboard behind chest THIRD STEP: apply the LUCAS and start GIFs lifted from this video: https://youtu.be/vIDJk3fA3sU?t=48 Whenever my team applies the backboard during a roll, it ends up getting tangled in sheets and […]
Let’s talk about mandible dislocations & how we can reduce them. First, we need to take a look at the mandible anatomy – can refer back to this as we discuss mandible dislocation: So how does the mandible dislocate (also called temporomandibular joint dislocation)? Causes: Now that we know mandible is out, can we reduce […]
Headaches are the most common complication of doing a lumbar puncture (LP). Let’s dive into what causes them, how to prevent them, and what to do when patients come back suffering from a post-LP headache. Some major theories on why post-LP headaches develop: Cause of the post-LP headaches is still highly debated! Theories: Timeline: Demographics: […]
