Have you ever wondered why you get so many epic chats reminding you to use the sepsis order set? Or why you are constantly reminded to reassess the status of your patient to see if they still meet sepsis requirements?  Well, there is a good reason, there is strong evidence to back up the use […]

My TR pearl this week is ethics-related and was inspired by the piece that Charles Sanky sent out last week, “Capacity, Informed Consent and Third-Party Decision-Making” written by Jacob Appel, a Mount Sinai Emergency Psychiatrist and Bioethicist.  I agree with Charles that this is an excellent introduction and encourage everyone to read this piece when you have the […]

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 […]