Yesterday we reviewed how to remove a fish hook. Today we will piggy back off that theme, and because summer is coming, review how to remove a tick. Aside from Lyme disease, ticks are capable of transmitting multiple diseases, includ…
Today’s pearl is courtesy of the sea and (the other) JP: how to remove a fish hook from human flesh. 1. Remove any fish hook flair – ie weights, lines, weird hair looking things, etc. 2. Clean the surrounding skin with betadine. 3. An…
Today’s pearl is courtesy of North Korea. They claimed that Otto Warmbier, an imprisoned American who unfortunately died a few days after his return to the US, had suffered brain damage after contracting botulism. If you think that sounds w…
Stiell IG, Wells GA, Vandemheen K, Clement C, et al. The Canadian CT Head Rule for patients with minor head injury. Lancet. 2001 May 5;357(9266):1391-6. PMID: 11356436 What we already know: Prior to this study, there was disagreement…
If you are unsuccessful with an LP, consider ditching the midline angle and instead approaching laterally. The lateral approach allows you to avoid the supraspinous and interspinous ligaments, which are often crunchy and calcified in older…
I was recently helping the resus resident with establishing peripheral IV access in a hemodynamically stable patient who needed to be urgently loaded with keppra. Multiple attempts by myself and 3 other providers were unsuccessful. I couldn…
Spiro DM, Tay KY, Arnold DH, Dziura JD, et al. Wait-and-see prescription for the treatment of acute otitis media: a randomized controlled trial. JAMA. 2006 Sep 13;296(10):1235-41. PMID: 16968847 What we already know: The most common…
A 1-week-old infant is brought in by his mother for decreased responsiveness and vomiting. Prenatal and birth history were unremarkable. He is cool, clammy, and lethargic. Nurses are unable to obtain a blood pressure, and he is hypoglycemic…
Today in resus, the nurse told me that one of the patients, a woman being treated with vancomycin, began to appear flushed and kept itching her face. The patient denied respiratory or GI complaints. She denied previous drug allergies, and h…
Bjornson CL, Klassen TP, Williamson J, Brant R, et al; Pediatric Emergency Research Canada Network. A randomized trial of a single dose of oral dexamethasone for mild croup. N Engl J Med. 2004 Sep 23;351(13):1306-13. PMID: 15385657 W…
Welcome to the inaugural post of the TR pearl series – Consultant Collaboration! If you’ve been watching or reading the news, you probably saw headlines about the new emerging superbug: multidrug-resistant (MDR) Candida auris. But did…
In 2016, ACEP published “Clinical Policy: Critical Issues in the Evaluation of Adult Patients with Suspected Transient Ischemic Attack (TIA) in the Emergency Department” in the Annals of EM. Here is a brief refresher. Transient ischemic att…
