“Childhood means simplicity. Look at the world with the child’s eye – it is very beautiful.” -Kailash Satyarthi Nursemaid’s elbow is a radial head subluxation, typically caused by a “pulling” mechanism. It occ…
Clinicians often consider alternate imaging modalities over contrast studies due to concern of acute kidney injury. In many situations, intravenous contrast can significantly improve the utility of a study. So, is contrast-induced nephropat…
The short answer is that it might. While it may not be surprising to you that ED crowding is detrimental to overall patient care, it may surprise you that it could be linked to inpatient mortality. At least a few studies have been looking i…
“Ventilation is the profound secret of existence” – Peter Sloterdijk Article Citation: Brochard L, Mancebo J, Wysocki M, Lofaso F, et al. Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N En…
“Nobody travels on the road to success without a puncture or two.” -Navjot Singh Sidhu Ultrasound can assist in determining the best site for lumbar puncture. Here is how to do it! 1. Palpate for the superior iliac…
Ketorolac is frequently used in the ER parenterally for acute and chronic pain control. Ketorolac works as a nonsteroidal anti-inflammatory drug (NSAID). It has demonstrated analgesic efficacy similar to opiates in postoperative pain. Ketor…
“Dogs never bite me. Just humans.” -Marilyn Monroe Human bites are the third most common bite after dog and cat bites. They occur more frequently in males, typically between the late teens and in the twenties. Clos…
Article Citation: Weiss EA, Oldham G, Lin M, Foster T, Quinn JV. Water is a safe and effective alternative to sterile normal saline for wound irrigation prior to suturing: a prospective, double-blind, randomised, controlled clinical trial….
“You must grow like a tree, not like a mushroom.” -Janet Erskine Stuart Amanita genus mushrooms cause a deadly toxidrome. Mortality is cited as 10-30%. The mushrooms can be identified by dots or scales on the cap. Cooking…
33-year-old G1 P0 at 39 weeks with a history gestational diabetes presents in labor. After delivering the head you see it retract slightly (turtle sign). On the next push you are unable to delivery the anterior shoulder with gentle downward…
Article Citation: Melniker LA, Leibner E, McKenney MG, Lopez P, Briggs WM, Mancuso CA. Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the first sonography outcomes asse…
This is a review of specific pediatric entities that may cause abdominal pain, bloody diarrhea, or vomiting. The following lists are not comprehensive and emergency physicians should consider a broad differential based on symptoms and prese…
The concept of “flow” or “being in the zone” is discussed often in sports but can extend to any activity. Being in the zone is described as an elevated yet effortless sense of concentration.1 Furthermore, it is considered to be intrinsicall…
Animal Bites (Cat, Dog, Monkey, Lizard, Snake) Quick bullets to prep for in-training, let’s review Management for ALL animal bites X-ray if suspect foreign body Remove teeth Routine wound care/irrigation Update tetanus Cats Pat…
Article Citation: Wong CH, Khin LW, Heng KS, Tan KC, Low CO. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med. 2004 Jul;…
