Tick Removal

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…

Fish Hook Removal

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…

Botulism

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…

52 in 52: Canadian Head CT Rule

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…

Lateral Lumbar Puncture

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…

Easy IJ

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…

Congenital Adrenal Hyperplasia

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…

Red Man Syndrome

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…

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