Leukostasis

Sometimes the most serious oncologic emergencies present very benignly: a slow nose bleed (portending DIC), a low grade fever (neutropenic bacteremia), vague weakness/fatigue (an undiagnosed leukemia)… The triage nurse calls you out t…

Hypertriglyceridemia

32-year-old, “otherwise healthy,” man with severe, sharp, epigastric abdominal pain. Your differential is broad enough, but you target a few questions: Drinker? (No.) Gastritis/GERD/PUD in the past? (No.) Gallstones? (No.) Smoke…

Drowning

It’s summer. Drowning is a tragedy that kills about half-million people each year worldwide, and is the second leading cause of traumatic death among children age 1 to 4 in the United States. Death from drowning (i.e. respiratory fail…

Slant-back Ingrown Toenail Repair

An intake / peds / fast-track chief complaint with an almost certain procedure: ingrown toenail. To state what may be obvious, this occurs when the distal portion of the nail has improperly grown into the lateral nail folds. It causes infla…

START Triage

As promised, another EMS-related post. Imagine yourself the first to arrive on the scene of a bus accident when you’re driving on your next road-trip vacation. Patients (limp, crawling, walking) are strewn about the street next to the…

EFAST vs CXR for PTX

Surgical resident X: “We have to get the chest X-ray before we go to CT.” EM resident Y: “Honestly, [surgical colleague X], I don’t think we do. The FAST didn’t have any evidence of pneumothorax, so I think we…

CRASH2 and TXA in Trauma

The use of Transexamic (spell that 10 times fast) Acid, or TXA, in trauma is largely based on the CRASH2 trial. This was a large, multi-center, randomized controlled trial with over 20,000 patients that demonstrated a mortality benefit of T…

Antibiotics in COPD Exacerbation

The term “COPD Exacerbation” is itself kind of ambiguous, but most definitions overlap with a patient carrying a chronic obstructive disease diagnosis presenting with increased sputum or cough, or increased shortness of breath r…

13 Dangerous Headaches

After spending 15 minutes or so reading through Reuben Strayer‘s how-to-present-to-him-as-a-med-student document (a systematic approach to the patient’s complaint, social situation, available resources, and physical exam), I wen…

1.7 million

FDNY EMS responded to over 1.7 million “jobs” in 2017, according to the FDNY annual report, with an average response time of less than 7 minutes to life-threatening emergency calls. You’re an ER doctor in New York City. Ti…

September 2022
M T W T F S S
 1234
567891011
12131415161718
19202122232425
2627282930  

Archives