Central Line Week

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…

Paxlovid: The Need to Know

Why Paxlovid: According to Pfizer’s clinical trial data from 2021 (participants enrolled by 09/29/2021) which it used for FDA approval, subjects who took Paxlovid were 89% less likely to develop severe illness and death from COVID than thos…

“Doc, I’m Blind!”

Super cool case, admittedly, maybe not a super high yield diagnosis BUT, I hope we can all agree, still very dope. Case: CC: 46yo M p/w worsening b/l vision over 1mo, now blind.  Vitals: WNL PMHx: L eye global rupture ~6mos ago 2/2 nail pen…

Visual Diagnosis

What do you think is going on here? So if you were the resident who signed up for this patient what would you do? As may be obvious, this is herpes zoster ophthalmicus, which is a reactivation of the VZV in cranial nerve V ophthalmic divisi…

What order of operations?

Cefepime + Vanc > Vanc + Cefepime Written by Erena Weathers So you’re in Resus, your very first one. Leibner is yelling, triage is yelling, and your sphincters are *tight*. Suddenly a nurse comes asking about your elderly septic pa…

Measles redux!

A quick search of sinaiem.org for the keyword measles brings up a solitary post from 2015, and it’s not actually about measles. With all the attention that measles has been getting in the news recently, now seems like a great time to revisi…

In honor of a rosh review question that I got wrong, lets review Lyme disease!   Lyme disease is caused by the spirochete Boriella burgdorferi, transmitted to humans through tick bites from ixodes ticks. Location: US, endemic in NE coa…

Meningitis Prophylaxis

Have you ever taken care of really critical, undifferentiated patient, only later to find out that they were diagnosed with a serious, contagious illness? We are exposed to innumerable pathogens each day in the ED, but there are only a few…

Abscess in need, pus indeed

So you thought I&Ding your abscess was enough?  Or your attending told you….no cellulitis so no antibiotics?  WRONG! A recent double-blinded randomized-controlled trial of outpatient children and adults with abscesses <= 5cm wh…

Ticked off

Today’s TR pearl is brought to you by Drs. Shearer, Hernandez, Sun and O’Halloran and summer in the Northeast. The weather is warm and people are flocking to the great outdoors. This means…ticks, as well as the tick borne diseases the…

Buruli Ulcer

The following scenario is based on a case that was seen in the Sinai ED this past week. A 52 yo M with hx of poorly controlled DM and HTN p/w rapidly progressing ulcer over the past 3 weeks of right lower extremity.  He has been afebrile an…

March 2024
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