Dripping in that Sedation

Today’s pearl: SEDATION DRIPS Titrating the sedation regimen on the sickest of patients can be one of the most challenging parts of the MICU. Anecdotally, many COVID+ vented patients in particular need at least 2, sometimes 3 different meds running at high doses to keep them comfortable, a phenomenon that also seems to have been noted in […]

Calcium Channel Overdose

For those who could not make it to VMR, we went over a truly sick calcium channel blocker overdose case. If not, here’s a quick rundown, and a link to the slides.   Briefly, the case was a 17-year-old female who reportedly overdosed on 60 mg of amlodipine (poor collateral, could have been more than that). […]

“Doc, I’m Blind!”

Super cool case, admittedly, maybe not a super high yield diagnosis BUT, I hope we can all agree, still very dope. Case: CC: 46yo M p/w worsening b/l vision over 1mo, now blind.  Vitals: WNL PMHx: L eye global rupture ~6mos ago 2/2 nail penetration requiring repair Pertinent HPI: First noticed previously injured L eye VA worsening, then good R […]

MRI Basics

As the stellar EM provider that you are, you’ve probably gotten pretty great at independently reading CTs, XRs, and even formal ultrasounds at this point. But what about the mysterious MRI? You know your consults need them, the radiologist will eventually read them, but it’s something that we don’t do ourselves quite often enough, usually […]

A can’t miss head CT finding

For today’s TR pearl, I’d like to take you back to January 2020, when covid was just a foreign virus and I was a fresh-faced intern, shadowing one of our recent grads, Dr. Sengupta in the cardiac room, along with Dr. Meyers. EMS called in a prenotification for a 63-year-old who was found by her family that […]

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