Extracranial internal carotid artery dissection can cause ischemic stroke by thrombus formation or thromboembolism and subsequent arterial occlusion. In fact, it is the 2nd most common etiology of strokes in patients younger than 45 years….
We’ve all heard that lidocaine buffered with sodium bicarbonate makes the local anesthetic closer to physiologic pH. This in turn decreases time of onset and infiltration pain. However, upon further investigation, this may not be so true….
When negotiations break down with an undifferentiated agitated patient, before you reach for your trusty 5:2, consider ziprasidone (Geodon). Martel et al. concluded that droperidol or ziprasidone achieved better sedation of the undifferenti…
Herpetic Whitlow – Viral infection of hand caused by inoculation of HSV into broken skin Hand pain disproportionate to clinical presentation Associated with influenza-like illness Clear vesicles coalesce and become purulent but…
We love our lactates and want to protect them from every slip and fall. But are they a bit more resilient than we think? Jones et al. concluded that point-of-care venous lactate in healthy patients does not significantly change over a cour…
Interpreting head CT’s can be daunting. But it doesn’t have to be. Just remember, “Blood Can Be Very Bad”. Blood – blood up to 1 week old looks hyperdense to brain – blood 1-4 weeks old looks isodense to brain…
Consider giving 2mg of lorazepam to your patient who’s back at baseline after one alcohol withdrawal seizure to possibly prevent recurrent seizures. This may even save you an admission as long as the patient has been at baseline without si…
Distinguishing early necrotizing fasciitis from severe cellulitis is difficult. In 2004, Wong et al proposed the LRINEC(Laboratory Risk Indicator for Necrotizing Fasciitis) score as a means to distinguish necrotizing fasciitis from other s…
Yes in fact we do have a massive transfusion protocol in place at Sinai. It’s quite amazing and surprisingly simple as long as the tubing system isn’t down. Follow the following steps. Call 46101 Ask for “Massive Transfusion Pack” Provide…
The incidence of hemorrhagic complications from large volume paracentesis (LVP) is unknown but hemoperitoneum from rupture of mesenteric varices is associated with a high mortality up to 70%. Signs and symptoms of hemorrhage can manifest fr…
