Background: SVTs are commonly seen in the ED. Chemical cardioversion often takes several minutes to initiate because we have to get IV access and medication ready. During this time, we can attempt some valsava maneuvers to cardiovert stabl…
What’s the difference between BiPAP vs. CPAP? CPAP stands for continuous positive airway pressure. In other words, there is a continuous pressure regardless whether the patient is breathing in or out. CPAP only has one pressure setting. BiP…
Background: Acute aortic syndromes (AAS) include aortic dissection, intramural aortic hematoma, penetrating aortic ulcer and aortic rupture. AAS are rare but life threatening cardiovascular emergencies with non-specific clinical presentatio…
4 Reduction Techniques of Anterior Mandible Dislocation Classic intra-oral reduction Place thumbs over the patient’s inferior molars Apply downward force and then guide the mandible posteriorly Wrist Pivot Method Place thumbs at the chin P…
Clinical Scenario: 28 yo F with unknown medical history presents with multiple seizures. Routine BMP shows hyponatremia to 110. What is your next step for symptomatic hyponatremia? Causes of hyponatremia: Hypervolemic Hyponatremia: congesti…
Despite warnings by the FDA in 2013 to stop prescribing codeine to children due to the risk of respiratory depression and death, a study to be released this week in Pediatrics indicates that 5% of children post-tonsillectomy/adenoidectomy a…
Article Citation Kuppermann N, Holmes JF, Dayan PS, Hoyle JD Jr, et al; Pediatric Emergency Care Applied Research Ne…
A 91 yo female presents with sudden onset right arm pain with decreased pulses. Since arrival to the ED, her mental status has also progressively decreased. Her blood pressure is 170/60, HR 60, T97.8, RR20, sats 100% RA. You suspect she has…
Article Citation Chang AK et. al. Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity…
17 yo female with progestin secreting IUD, LMP 9/22/17, no prior medical problems presents to the ED with bilateral lower abdominal pain for the last day. She also notes that she has had some intermittent vaginal bleeding for the last 3 wee…
Article Citation Hacke W, Kaste M, Bluhmki E, Brozman M, et al; ECASS Investigators. Thrombolysis with alteplase 3 t…
21 yo male presents with laceration over his distal 4th metacarpal. Initially the patient doesn’t recall how the injury occurred, but with additional probing you discover he was in an altercation last night and punched another person in the…
A 74 yo female with hx of diabetes, HTN presents to the ED with new onset painless left sided diplopia for the last 24 hours. No change in visual acuity. The patient has no other symptoms. You examine the eye and left sided ptosis and a “do…
Article Citation: The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute iscAhemic stroke. N Engl J Med. 1995 Dec 14;333(24):1581-7.PMID: 7477192 What we already knew abo…
