Today we will review complications associated w/ implanted pacemakers that you may encounter in the ED and thus ought to be familiar with. Generally, complications can be divided into two categories: early vs. late Early complications typic…
Cardiac pacing as an intervention can be conceptualized as addressing problems in electrophysiological conduction and/or. So, for example, if there is a disruption in the electrical continuity between the atrium and the ventricle, a pacer…
The pursuit of mastery over cardiovascular emergencies demands a rough familiarity with implanted devices which includes why they get implanted in the first place (indications), how they work, how they malfunction, and how they affect the E…
Your patient has an SBO and has repeated bilious emesis on the side. The surgery team is in the OR and they ask if you can place the nasogastric tube (NGT). Lets review proper NGT placement and some new techniques that can facilitate placem…
At the request of a colleague who recently treated a patient bitten by a monkey, I am going to write about treatment and prophylaxis for animal bites. First, a little BIT (get it?) about monkey bites. These are relatively rare in the US, pr…
So you’re in peds and your patient is anemic. You need to transfuse, but you are confused. How much blood do you give? How fast do you give it? How much: The volume of blood to be transfused may vary depending on the clinical scenario…
Your patient is a 24 yo M with chest pain. It is pleuritic. He has normal vitals and you’re not too concerned. You get a CXR and you see the result in this post. He has pneumomediastinum! What is that? What do I Do now? Spontaneous p…
You are on a flight, halfway across the Atlantic Ocean at the start of a much needed vacation, binge watching that new show everyone has been talking about but you’ve never had time to see. Suddenly, the screen freezes and an overhead anno…
Your patient with a newly diagnosed PE hates hospitals. He or she agrees to defer to your judgement about admission versus discharge home, but makes it clear they would prefer to go home if it is safe. Which tool should you use to…
We give out canes like they’re candy. But are we doing a good job adjusting the cane and teaching patients how to use them? Canes that are not the right height for your patient or are being used incorrectly can put patients at an even gre…
A patient comes to the emergency department reporting a few days of excruciating pain in a band around his right chest. Today, he developed vesicles over the same area which prompted him to come in. Classic shingles. Like most patients d…
You are the leader of the code team. Your patient is in refractory VF after multiple rounds of shocks and drugs. You’ve tried repositioning the pads into an anterior-posterior position. Looking around, you ask for suggestions. So…
It’s 1 am and things are winding down. The trickle of patients has slowed and it actually looks like you and your team are catching up. Suddenly, you hear yelling, swearing and crashes coming from triage. Other patients are lookin…
Ah, cold and flu season. It’s that joyous time of year when our department is flooded with miserable people complaining of sinus headaches, rhinorrhea and feeling terrible. We all know that for most viruses, symptomatic care is the way to…
Penicillin allergy is a common finding in many patient charts. Sometimes it can be difficult to figure out who, when and why this label was added to a medical record. Sometimes patients themselves perpetuate the label, unwittingly…
