You have a patient who is in acute renal failure. You have sent an ER-venous panel that shows a Cr of 4.6, a BUN of 95, and a K of 6.5. You discuss these findings with your nephrology colleagues who request you get the “more accurate” basic…
74 yo F with hx of CAD, afib, HLD, severe LV dysfunction is brought in by EMS as a notification for a STEMI. A 12-lead EKG in your ED shows the same as the EMS EKG. Should you activate the CATH lab? Answer: Check an old EKG. An old E…
So, you’ve just finished suturing an uncomplicated laceration and you think to yourself: should I apply antibiotic ointment or just cover with a bandage with good return precautions? Answer: There is some limited evidence to support…
Article Citation: Andersen HR, Nielsen TT, Rasmussen K, Thuesen L, et al; DANAMI-2 Investigators. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction. N Engl J Med. 2003 Aug 21;349(8):733-42. PMID:…
There may be. Traumatic lumbar punctures occur in up to 30% of lumbar punctures. An observational, multicenter cohort study by Jeffrey Perry et. al. attempted to answer this question and enrolled sequential patients with acute…
A 3 week old male, born NSVD 40w6d, presents to the ED with 2 days of feeding intolerance. Initial vitals show a heart rate of 260, bp 83/51, RR 40, sat 100% RA, temp 37C. You quickly get an EKG pictured below that shows a regular, narrow c…
Source: See citation below Pearl: When applying the Ottawa Ankle Rule, we specifically palpate the posterior maleoli. Explanation: When reviewing the Ottawa Ankle Rule today during morning report the question came up: why do we specificall…
Note: Some of the junior residents are unaware of what the 52 in 52 Review is. In brief. The ALIEM blog picked a list of 52 influential papers in EM (we are on version 2 now) to provide a weekly reading topic. The full list is available her…
By Jer5150 – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19669589 Pearl: In cardiac arrest, consider esmolol (500mcg/kg loading dose, then 0-100mcg/kg/min drip) for refractory ventricular fibrillation. Back…
My Hospital computer would not permit an image pertinent to this post to be downloaded without admin privileges, so here is a photo of Quinoa. Pearl: Lidoderm 4% patches are available over the counter. Lidoderm 5% patches are prescription o…
