Resist the urge to administer a large crystalloid bolus in hypotensive trauma patients. Doing so worsens coagulopathy and acidosis. This practice should be abandoned. Normotensive trauma patients need no fluid resuscitation. The practice of…
It’s well known that the risk of venous thromboembolism is increased during pregnancy. It is thought to be two-to-six times higher than the risk in non-pregnant women. However, these risk estimates are based on pregnant populations…
A few days ago NEJM published the results of an investigation with profound implications for our specialty. A group of intensivists and anesthesiologists conducted a multicenter, randomized trial conducted in seven ICUs to study the use of…
At the request of department leadership, we will be revisiting methods of gastric decontamination for today’s pearl. Two methods in particular. Ipecac-induced emesis and gastric lavage are two procedures that we read about in medical…
Today we will review complications associated w/ implanted pacemakers that you may encounter in the ED and thus ought to be familiar with. Generally, complications can be divided into two categories: early vs. late Early complications typic…
Cardiac pacing as an intervention can be conceptualized as addressing problems in electrophysiological conduction and/or. So, for example, if there is a disruption in the electrical continuity between the atrium and the ventricle, a pacer…
The pursuit of mastery over cardiovascular emergencies demands a rough familiarity with implanted devices which includes why they get implanted in the first place (indications), how they work, how they malfunction, and how they affect the E…
In honor of a rosh review question that I got wrong, lets review Lyme disease! Lyme disease is caused by the spirochete Boriella burgdorferi, transmitted to humans through tick bites from ixodes ticks. Location: US, endemic in NE coa…
Your patient has an SBO and has repeated bilious emesis on the side. The surgery team is in the OR and they ask if you can place the nasogastric tube (NGT). Lets review proper NGT placement and some new techniques that can facilitate placem…
Inspired by what appears to have been a very interesting day in the Peds ED, lets review a rare but interesting pediatric entity: PYLORIC STENOSIS Background: MC in Males (5:1) & firstborn children (30%) Usually begin between 3-6 wks of…
At the request of a colleague who recently treated a patient bitten by a monkey, I am going to write about treatment and prophylaxis for animal bites. First, a little BIT (get it?) about monkey bites. These are relatively rare in the US, pr…
