This post is meant to be an update to yesterday’s post on the CDC recommendations regarding Tamiflu. Most of this information will be based off of a 2014 Cochrane Review. Toward the end of this post I will delve into the controversia…
There is a lot of controversy surrounding the use and efficacy of Tamiflu. Below is a brief review of Tamiflu per the CDC. TL;DR -Likely some benefit in elderly (>65y/o), young (<2 y/o), chronically ill, or hospitalized patient…
We don’t often put in subclavian TLCs in the ED because of the increased risk of complications, specifically pneumothorax. Often, it’s difficult to do with US guidance so we turn to placing IJ TLCs instead. However, there are ce…
Case You receive RESUS signout on a 60F DMII, HTN here with urosepsis s/p abx, lactate downtrending, BPs holding in the 90s-low 100s systolic with IVF. Only thing left to do is talk to the MICU. You note the patient to be in persistent afib…
Should patient with severe sepsis receive steroids? Multiple trials have evaluated this question with varying results The ADRENAL Trial sheds some light on this question. The answer: Probably not TLDR: Does hydrocortisone reduce mort…
Today’s TR Pearl was inspired by an actual in-flight emergency i helped out with last year. The Case You’re on a flight home from vacation, finally fell asleep only to be woken up by your girlfriend: “Wake up, that passeng…
Noninvasive cardiac testing comes in multiple forms. There is the dobutamine or exercise stress echocardiography (DSE/ExSE), myocardial perfusion scintigraphy (MPS)–single photon emission computed tomography (SPECT), and cardiac magnetic re…
You’re in your Intake/Fast Track shift and you see a 94 year old patient who had a trip and fall earlier today and now has elbow pain. The elbow is tender and xray shows a fracture dislocation. You call your local ortho and they want…
So you’re working your pediatric shift again and you see a child who fell and hit his chin on a table and now has a tongue laceration which you’ve deemed needs repair (see prior post for criteria). How are you going to anestheti…
You’re in a small community ED and the only overnight doctor and you’ve found yourself with a difficult airway. Direct laryngoscopy has failed, video didn’t get a great view, bougie was surprisingly unhelpful, your LMA isn…
With the NFL Wild Card Weekend almost upon us, the talk of head injuries could never be higher. Professional athletes are evaluated by multiple physicians when at risk for a concussion, but what do you do when you have that 16 year old who…
You’re working your pediatric shift and you see your next patient. It’s a young boy who while running had fallen and hit his head, had initially had some bleeding from the mouth and was crying but is now better and no longer ble…
