Don’t Be Rash

Do you ever have a patient with a rash you just don’t recognize?  If you’re like me, it happens all the time and it can be hard to organize your differential.  Michelle Lin (https://aliemcards.com/cards/rash-unknown) published a…

Buprenorphine Band Wagon

Do you know David Cisewski?  He’s incredible and he’s written an incredible review on buprenorphine (http://www.emdocs.net/buprenorphine-where-do-we-stand/) that I’d like to tell you all about. Buprenorphine marketed as Su…

Ultrasound and Found

Ultrasound for kidney stone has always been confusing.  If we do the ultrasound and find no hydro, don’t we need the CT to rule an alternate diagnosis?  If we do the ultrasound and find hydro, don’t we need a CT to see if the st…

Old Graft? New friend!

ESRD patients are typically “hard sticks.”   The arm with the fistula is typically off limits (unless in emergency settings) and the other arm is either difficult to access or occasionally has an old fistula. This issue came up…

The Supraclavicular Subclavian

Traditionally, central line placement in the subclavian vein (SCV) involves a landmark-based approach in which the needle is guided under the clavicle. For the U/S lovers, there is an alternative approach to the subclavian in which the sono…

The Neuroprotective Intubation

Bottom line up front: (1) Intubating those with TBI or spontaneous ICH is dangerous. You want to prevent increased ICP that is caused by laryngoscopy. (2) Pre-treat with fentanyl if time and the pt’s BP allow. The dose of fentanyl is larger…

Dislocated knee? Get the CT.

Knee dislocations are a dangerous and easily missed diagnosis.  Morbidity is high as 20% have a serious vascular injury, many of which lead to amputation.  This can occur with even ground levels falls in elderly and obese patients, so a hig…

August 2018
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