We’ve all seen the patients roll in with EMS nasal cannula snug against their nares. “Why are they on oxygen?” EMS response, “I don’t know he was having chest pain.” EKG shows STEMI! The last thing you…
Dr. David Forsh’s review yesterday of compartment syndrome made me realize how rarely we see this life-threatening diagnosis. So what do we need to know? What’s the etiology of compartment syndrome? Majority cases 2/2 Fractures…
Chest pain…everyone gets it…sometimes when a patient says they have chest pain I get chest pain. What’s the solution to this chest pain epidemic? Troponins! Well not so fast because they aren’t fast…especially…
Have you ever had those patients that are agitated? In a Zombie-like frenzy they rip out all their lines and extubate themselves in the CT scanner agitated? I think we’ve all been there (hopefully with something for sedation in hand!)…
So you’ve I&D’d that abscess, there’s no surrounding cellulitis you’re ready to Treat em’ and Street em’ but the patient asks: “Can I have some antibiotics, please? And maybe a sandwich?”…
Left Bundle Branch Blocks (LBBBs) are scary because they can be confused for MIs and MIs are scary…almost as scary as Y2K. Which takes us back to the 90s…the good days, good music, great hairstyles, and Sgarbossa! 20 years ago w…
What do all these EKGs have in common? They are all hyperkalemia! How hyperK+ are they? Turns out it is probably hard to say…there’s a Basic Rubric: P…
SBO you say? 6-infinity hours until dispo?! Sometimes it feels like you want to just rub a lamp and all your dispo decisions would be granted! Maybe it can!? Enter SBO and ultrasound! What are you looking for on US? (Westafer & Faust 20…
Chest tubes hurt…I imagine. And the few times I’ve done them (x2) I’ve wondered couldn’t that person have just gotten a pigtail?! What does the literature say? Voisin et al 2014 asked if large pneumothoraces (>2-3…
This case was brought to my attention by the wonderful Sam Schuberg. Impressively he drained a large pleural effusion in the ED offering his patient “Upstairs Care Downstairs”. He then brought to my attention that when dr…
First thing that probably comes to mind when you hear peripheral vasopressors is “when is this patient getting a central line (CVC)?” or “COWBOYS!” because as ED docs that is what we are and how else to express that…
The Stats: 350,000 out-of hospital cardiac arrests (OHCA)/209,000 in hospital cardiac arrests (IHCA) each year (2016) Majority of cases have a primary cardiac etiology with vfib as presenting rhythm So SHOCK IT!…..Surviv…
This Sept 2015 Annals of Surgery article made a splash when it first came out a year ago, and it came up again yesterday in conference. Here’s a refresher. FAST ultrasound examination as a predictor of outcomes after resuscitative tho…
We do a lot of diagnostic taps at our shop. People need to take better care of their livers. Here’s a tip for your next tap. I recently encountered a very obese cirrhotic patient who required a diagnostic tap. He had several very deep…
Today, instead of talking about tapping a joint to pull fluid out, we’re going to talk about tapping a joint to put fluid in. Methylene blue, in fact. The methylene blue joint injection test is a fast and simple bedside test that can…
