Let’s talk about large bore/central vascular access! We’ll review different kinds, their different names, and when to use them!Of note outside the scope of this review: how to insert each of these – I think this is better learned by watchin…
This week, I wanted to touch a bit on Meconium Aspirators as apart of our GI Bleed intubation tool kit. At some point during second year, many of my fellow classmates and I started throwing these into airway boxes at Elmhurst. Especially in…
Central Line Week TR Pearl Series (all three pearls combined for this post) by Ryan LeBuhn, PGY-3 Informed Consent I once described the risks of a procedure so thoroughly that the patient no longer wanted the procedure, though avoiding the…
By Lara Silverman, MD/MPH Emergency Medicine PGY3 Pressors are used in hypotension. Per Scott Weingart, there are three main reasons we use pressors: Maintain critical perfusion pressors, especially to the brain, heart, and kidneys. B…
Vital Signs: HR and BP Traditionally in medical school we were taught that physiologic changes in pregnancy caused a drop in BP and an increase in HR but generally it was not well-defined if a new range of criteria was required to be consid…
Myasthenia Gravis: Disease Overview Who: Bimodal distribution. Ages 20-40 (female predominance) and 50-70 (male predominance). Increased risk of onset in postpartum period; juvenile and congenital forms possible What: At the NMJ, Ach recept…
Today’s pearl: SEDATION DRIPS Titrating the sedation regimen on the sickest of patients can be one of the most challenging parts of the MICU. Anecdotally, many COVID+ vented patients in particular need at least 2, sometimes 3 diff…
For those who could not make it to VMR, we went over a truly sick calcium channel blocker overdose case. If not, here’s a quick rundown, and a link to the slides. Briefly, the case was a 17-year-old female who reportedly overdosed on 60 m…
In addition to his love of ketamine and proper PSA technique, Reuben Strayer has written and talked extensively about ED intubations. Here is his checklist so that you can minimize complications and maximize your success: For more informati…
Perhaps never explained so clearly, Cisewki and Alerhand’s article on EPSS is a wonderful read. Bottom line to remember: EPSS > 7 mm was 87% sensitive and 75% specific at identifying reduced EF (<50%). This is the cutoff genera…
Neonatal Resuscitation. (Some descriptors for reference: Terrifying. Scary. Fear-inducing. Horrific. Chilling.) But fear not! Your TR pearl today is brought to you by the NICU rotation + Jillian Nickerson/T.Webb doing some excellent prepara…
So you’re in the ED and a G9P8 patient at 40w2d rolls in with contractions every 3 minutes. Before sending the patient upstairs you do a brief examination and you see this… You deliver the baby flawlessly and even protect…
Needle, wire, nick, dilate, catheter. Sounds simple right? However, simple doesn’t always mean easy. Placing a central line on a mannequin can be much easier than the 250lb ESRD patient with peripheral vascular disease and a MAP of 50. Belo…
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…
There have been a few cases of supra-therapeutic INR in the Sinai ED recently, and at the request of one of our superstar interns, below you will find a brief set of recommendations regarding Supratherapeutic INR. The following bolded recom…
