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…
With the arctic blast sweeping through the country, the incidence of patients with severe hypothermia is likely to increase. So what do you do when you’re sitting in the cardiac room and EMS brings in a patient with a very low core te…
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…
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…
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…
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…
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…
It’s early medical school teaching that pregnancy puts a patient at increased risk for thrombotic diseases like DVT and PE, but what can you do when you actually find one? Classic teaching and a quick poll of our residency (n=4) has e…
