Scenario: The images from your patient’s non-contrast head CT are finally uploaded and it looks negative. Unfortunately, your patient has been having severe symptoms for almost 24 hours and you know this single study is not sensitive…
In honor of 5/20/16, a day in which the Sinai ED managed three cardiac arrest patients in less than one hour, I wanted to post a pearl relevant to one of the cases we saw. Our initial goal during a Vfib arrest resuscitation is to optimize u…
The WHO declared a Public Health Emergency of International Concern on February 1st, 2016 due to the outbreak of microcephaly and Guillain-Barre Syndrome cases associated with the Zika virus. Here’s a quick review of what we do and do…
I could bullet point plenty of statistics, but I don’t think I have to convince you: there is an opioid epidemic and it is getting worse. We all have treated patients for opioid overdose in the ED. We also frequently identi…
Once you understand the basic functions of the components of your arterial line set-up and know how to position it properly the next level of mastery involves spotting other errors and optimizing them. If you notice that your pulse pressure…
I can count the number of severe burns I’ve seen in residency on one hand. I suspect that’s true for many of us, especially if you don’t work at a burn center. The problem is that these patients can be really sick and requ…
Often in the ED we are faced with a patient who is on anticoagulation and needs an urgent procedure. Lumbar puncture is a very safe procedure overall, but it’s particularly dicey in the setting of anticoagulation because of the possib…
Today we bring you a compilation of several tips to make your next central line go more smoothly. Interns and 2nd years will probably find these tips most useful, but you’d be surprised how much you can pick up even as you get further…
Chest pain: the bread and butter of emergency medicine. We see so many of these that it can be mind-numbing, and for EXACTLY that reason it’s critical to recognize those weird EKGs that aren’t an obvious STEMI but can signal a c…
Let’s say you’re seeing a 65-year old guy who is coming in for cough, and malaise. Plus, he was recently diagnosed with atrial fibrillation and started on coumadin, but hasn’t really been going to his appointments because…
The hardest part of intubating your sick patient shouldn’t be the gastric tube. That’s what med students are for, right? Unfortunately, NG or OG tubes can be frustratingly difficult to place. A couple researchers from anesthesia…
As ER docs, we see more EKGs per day than 95% of doctors out there. To survive, you have to be good at recognizing the big EKG findings, like STEMI, pericarditis, PE, and a multitude of arrhythmias. But if we’re honest, there’s…
Everyone loves a good intubation on an otherwise long and dreary resus shift. You’re at the head of the bed, totally boss, giving commands to your attending to ‘pass me the tube’, and it feels great when that cuff passes t…
Among the least commonly utilized intubation techniques stands the humble digital intubation. The name says it all: the intubator uses their index and middle finger like a miller blade to locate (by palpation) and lift the epiglottis before…
The thin, friable skin of elderly patients can present a special difficulty for laceration repair. If you find yourself pulling through the skin as you try tighten knots, applying steri-strips along the edge of the skin can serve as a forti…
