Weathering the Storm

You’re in the resus room having your morning bottle of water when the triage nurse rolls in your new patient. Diaphoretic, talking but lethargic appearing, and, when placed on the monitor, showing this: Being the astute resident that…

Getting the Finger

Hand pain: a chief complaint that can be seen at any level of emergency medicine. But do you know what to do if your patient has finger trauma involving the nail and happen to be in a place without a hand service to consult your troubles aw…

Tis the Season!

Its a holiday weekend. The decorations are up. Presents will soon be unwrapped. A beautiful tree is decorated and lit. But did you know your living room of festivity can be a death trap in the making? For example, the beautiful holly on the…

Less is more?

You’re halfway through your pediatric overnight shift and you have a 15 yr old come in brought in by his parents. You see him with his head turned all the way to the right and in some amount of pain. You open up his chart and note mul…

You moving, bro?

We’ve all been there. The patient in respiratory distress (or any other reason) that you’ve now decided needs an intubation. You’re all set up, you’ve done your checklist, you’ve done your time out, and the med…

Flomax for Ureteral Stones?

Using Flomax for ureteral stones has been a controversial topic. A meta-analysis of 8 randomized controlled trials consisted of 1,384 patients showed that there was no benefit in giving Flomax to those with ureteral stones < 5mm. However…

Intranasal Fentanyl

Delivering adequate analgesia in pediatric patients in a timely fashion is difficult. IV route requires staffing and produces additional pain and anxiety in this population. However, the oral route has a delayed onset. The benefit to IN fen…

Etomidate vs. Ketamine

Both etomidate and ketamine are commonly used as the induction agent for RSI in adult trauma patients. There are concerns about etomidate-associated adrenal suppression leading to complications in critically ill patients. This is a retrospe…

Epistaxis

The current treatment for epistaxis consists of holding pressure, local vasoconstrictor, silver nitrate or anterior nasal packing. Recently, the use of topical TXA has been purposed. A previous study in 2013 showed that topical TXA resulted…

Albumin in SBP?

We have many patients coming to our ED with cirrhotic liver disease with ascites. Up to 25% of patients with ascites have SBP. Once SBP has been identified, we use a third-generation cephalosporin to treat the patient. However, the benefit…

December 2017
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