Does roc rock and suc suck?

A study just published this month in Annals of Emergency Medicine compared the 2 most common paralytics we use in the ED for RSI, rocuronium and succinylcholine. The primary outcome studied was first pass success rate, and the secondary out…

Opioid Conversions

Shoutout to RTO for this tidbit he learned from palliative care on a quicker way to do opioid conversions. Thought I’d share it with you all! Have you had patients who are on opiates at home, need pain relief, not exactly sure how muc…

Acute Flaccid Myelitis

We’ve gotten an email or two telling us to look out for Acute Flaccid Myelitis (AFM). What is it? Why does it matter? AFM causes flaccid weakness to one or more limbs rapidly in a polio-like neurologic fashion. There can also be crani…

To bicarb or not to bicarb

When, if ever, should we be giving bicarbonate in patients with metabolic acidosis? A study published in The Lancet in July 2018 involved a multicentre RCT in 26 ICUs with 400 patients, called the BICAR-ICU trial. It found that in severe ac…

PTSD in EM Residents

Winter is here. It’s colder. Sometimes we don’t see the sun for days. Let’s take a moment to think about some mental health issues. Published in Annals of Emergency Medicine in December 2017 was a piece by some of our very…

Foot vs Bus

In a totally hypothetical situation, imagine a resident’s foot got run over by a bus and looked like this after arriving in your ED… What sort of things should you be concerned about in injuries like this of extremities? 1. Vasc…

The Golden S Sign

Shoutout to the awesome David Cisweski for following up this tidbit from conference and giving us this pearl. Remember in conference when Dr. Jacobi was going over chest X-rays, was talking about the Golden S sign, and we could neither see…

SVT and Paranasal Etripamil

Have you had one of those resus shifts where everyone and their mother seems to be in an arrhythmia? Have some of them been older patients with SVT that just make you a little antsy about giving medications like adenosine multiple times aft…

Air Pollution and Stroke?

One growing global health issue is ambient air pollution. One of the leading risk factors for disease is fine particulate matter in outdoor air. The WHO states 1 in 8 deaths is due to air pollution. So what is it’s effect on cerebrova…

Nursemaid’s Elbow Reduction

Radial head subluxation, more commonly known as nursemaid’s elbow, can be seen more frequently in the pediatric population. Imagine a parent quickly pulling a child’s arm (usually 1-4 years old) that was held in extension in ord…

June 2022
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