Cervical artery dissection (CAD) accounts for 1-2% of all ischemic strokes but 10-25% of strokes in younger individuals. CAD includes extracranial carotid and vertebral artery dissections. A review of the literature suggests that there ma…
ED physicians need to be comfortable with the various modalities of opioid substitution therapy (OST) and their associated complications. We are all familiar with the patient who has missed a daily dose of methadone on the way to booking a…
There are approximately 8 million ED visits annually in the United States for chest pain. 10%-20% go on to receive an acute coronary syndrome diagnosis. The goal of the ED physician is to differentiate between ischemic chest pain and other,…
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…
