The 52 in 52 Review: ProCESS

Title: “The 52 in 52 Review: ProCESS” Article Citation: ProCESS Investigators, Yealy DM, Kellum JA, Huang DT, et al. A randomized trial of protocol-based care for early septic shock. N Engl J Med. 2014 May 1;370(18):1683-93. PMID: 24635773….

Spin to Win

Dr. Michael McGonigal’s Trauma Professional’s Blog is a fantastic web resource with a nice, free monthly newsletter. I’ve been reading it regularly since medical school, and I’m pretty sure it’s the first place…

A Whole New World

We all love FOAM, and we all love airway. Today’s pearl will introduce you to a corner of FOAM you may not have come across, as well as a corner of airway management you might not know about. I’m a big fan of Jed Wolpaw’s…

Hard Numbers and Blood Transfusions

Not infrequently we identify patients who need to have some sort of blood product transfused in the ER. Most of these patients are not crashing, and have time to have a formal conversation about risks, benefits, and alternatives to transfus…

Oops…is that part important?

There you were, minding your own business when EMS brings you a sick-as-can-be patient, intubated in the field for who knows what. Someone gets overzealous with their trauma shears and cuts off the pilot balloon on the endotracheal tube. Th…

Ketamine for acute pain in the ED

Deaths from heroin rose to 8,260 in 2013, quadrupling since 2000 and aggravating what some were already calling the worst drug overdose epidemic in United States history. Overall, drug overdoses now cause more deaths than car crashes, with…

Determining Capacity

A 74 year old female with a GI bleed is refusing treatment, stating that she just wants to go home rather than being transfused for her hemoglobin is 5. You attempt to convince her to stay but she steadfastly says that she just wants to lea…

Globe Subluxation

Apologies for the lack of recent pearls. Now that the website is back up and running, we’ll be going back to our regularly scheduled programming. “Hey doc, my eyeball popped out”. It’s a chief complaint that we don…

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…

Burn Baby Burn

Happy 4th of July! I’m taking the day to review a commonly incurred injury on the holiday: burns. Whether it’s from operating a grill after a few too many libations or an unfortunate encounter with fireworks, the incidence of bu…

Tick Removal

Yesterday we reviewed how to remove a fish hook. Today we will piggy back off that theme, and because summer is coming, review how to remove a tick.   Aside from Lyme disease, ticks are capable of transmitting multiple diseases, includ…

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