We have a new resource in the Sinai ED. Say hello to your friendly ED pharmacist. In the past several years, the ED pharmacy has been centralized in a non-ED location. We all know well these faceless interactions with a human reminding you…
Perhaps never explained so clearly, Cisewki and Alerhand’s article on EPSS is a wonderful read. Bottom line to remember: EPSS > 7 mm was 87% sensitive and 75% specific at identifying reduced EF (<50%). This is the cutoff genera…
Whether it’s asthma, a U.R.I., or post nasal drip as the cause, cough is a common enough complaint encountered by emergency physicians everywhere. Of course you must always rule out the dangerous causes of cough (PNA, Measles, PE, Heart fai…
Disclosure: I’m a huge Apple Fan. Unless you’ve been living under a rock, you’ve heard about the Apple watch, many of you reading this are wearing one right now. On April 24th, 2015 it joined a long list of wearable wrist…
Today’s post is inspired by real-life events and comes with a video (consent given by the patient and providers). The case: 29M presents with dysphonia, odynophagia, and drooling. He is hypertensive, with a low-grade fever, but he is…
For those of you who remember Super Mario Bros… how awesome was it to gobble up that red and white mushroom gliding along the ground and get huge for a few seconds? The result of consuming this mushroom was a bigger and badder Super M…
You ever have a tough time visualizing P waves on EKGs? Have no fear, a Lewis Lead EKG might just be the thing you need! The Lewis Lead (aka S5) is a modified EKG obtained in a manner that basically triangulates atrial activity to help make…
Hey there guys and gals and welcome back to my channel! If you’re like me and TERRIBLE at reading your own imaging studies, settle in for a quick 20 minute run down for all those CT heads everybody be ordering without a second though….
Continuing with the theme of clinical informatics, today we will touch on the topic of Clinical Decision Support Systems (CDSS), or sometimes just called Clinical Decision Support (CDS). The basic premise of clinical decision support is tha…
If you loved the super sexy topic of cerumen impaction yesterday…Well, hold on to your socks, because today we will continue our rousing educational foray by tackling the riveting question: What is Clinical Informatics? Shall we begin…
The last time www.sinaiem.org addressed the topic of cerumen (ear wax) impaction was in 2013. See this post: http://sinaiem.org/50yo-man-with-chest-pain-and-also-with-r-ear-pain/ If you’re like me, you likely believe that the world of ceru…
There are approximately 8 million ED visits annually in the United States for chest pain. 10%-20% go on to receive an acute coronary syndrome diagnosis. The goal of the ED physician is to differentiate between ischemic chest pain and other,…
Resist the urge to administer a large crystalloid bolus in hypotensive trauma patients. Doing so worsens coagulopathy and acidosis. This practice should be abandoned. Normotensive trauma patients need no fluid resuscitation. The practice of…
It’s well known that the risk of venous thromboembolism is increased during pregnancy. It is thought to be two-to-six times higher than the risk in non-pregnant women. However, these risk estimates are based on pregnant populations…
A few days ago NEJM published the results of an investigation with profound implications for our specialty. A group of intensivists and anesthesiologists conducted a multicenter, randomized trial conducted in seven ICUs to study the use of…
