A young patient comes into your RESUS area complaining of palpitations, and you get handed this EKG. What do you do?
@JoePinero GI bleeds have been a subject of significant research over the past decade. Let’s review the Rockall risk stratification tool. RISK STRATISFICATION TOOL ROCKALL SCORE: Score > 3 = good prognosis (rebleed < 11%, mortal…
@JoePinero Every critical care physician scoffs at the idea of placing a femoral central line, but are they correct? Do femoral central lines actually cause more infections than other sites?
Post by @FTeranmd Using a systematic approach when reading a brain CT will make you a better doctor Because you only see what you’re looking for. Don’t believe? watch: http://goo.gl/6sIZ9x A simplified and systematic approach to the evaluat…
Post by @Fteranmd Thinking outside ACLS: Summary slide for conference lecture -Pathophysiology of Cardiac Arrest- http://edecmo.org/intra-arrest-goal-directed-monitoring-beautiful-nutshell-felipe-teran-md/
Post by @FTeranmd Image from Jacob et al. Heart Rhythm. 2011 Jun;8(6):915-22 We’ve all had a patient who shows up at the ED with a pacemaker or implantable cardioverter-defibrillator (ICD) that may be malfunctioning. The patient didn…
Post by @FTeranmd Clinical scenario: 72 yo F with history of lung carcinoma with permanent trachestomy placed four months prior presentation, brought by EMS with profuse, active bleeding from the stoma site. Patient is ventilator de…
Case: 45yoF with myasthenia gravis presents in respiratory distress. She requires urgent intubation. Which paralytic will you use? Myasthenia gravis is an autoimmune neuromuscular disorder in which antibodies target nicotinic acetylcholi…
55 yoF h/o HTN presents BIBEMS with acute onset decreased level of consciousness, onset 3 hours prior to arrival. BP 220/140 HR 50 T 98.0 RR 10 SPO2 92%. Pt is obtunded, no localizing neuro findings. Pt intubated for airway protection. CT s…
A 75M presents with several days of cough, fever, and progressive lethargy. CXR demonstrates RLL pneumonia. BP 70/50. HR 130. Lactate 5. T38.0 2L bolus NS given. Antibiotics started. Bedside sono shows noncollapsing IVC, hyperdynamic LV. Re…
Thirsty (for knowledge) Thursday Patient is 72 yo F wtih PMH of HTN, severe aortic stenosis presented to ED with dizziness and shortness of breath, progressively worse over the last 2 weeks, both symptoms worse with exertion. Patient…
4 teasers for the 4th of July weekend. 1. What is this and why is it dangerous? 2. Patient had a DVT + PE, then got an IVC filter, then had another PE. How? 3. Fun Sporcle quiz – 3 letter body parts, 2 min 4. Higher level Sporcle quiz…
All of us have placed central line before. You enter the vein under ultrasound. The wire threads easily, or maybe there is a little resistance, but the wire passes anyway. You dilate, place the catheter and suture it in place. You then o…
A 33 yo man presents to the ED with multiple complaints 2 hours after completing a scuba dive. Which of the following symptoms indicates a need for recompression therapy? Decreased hearing Ear pain Epistaxis Knee pain Petechial rash
65 yo M PMH of HTN, CAD, CHF (EF <30%), AICD wheeled into the cardiac room saying that he is getting shocked every 30 seconds. Vitals: T 36 HR 45 BP 205/100 RR 30 O2 sat 100% RA. Pt is placed on a monitor, EKG done which shows atrial fib…