Have you had one of those resus shifts where everyone and their mother seems to be in an arrhythmia? Have some of them been older patients with SVT that just make you a little antsy about giving medications like adenosine multiple times aft…
One growing global health issue is ambient air pollution. One of the leading risk factors for disease is fine particulate matter in outdoor air. The WHO states 1 in 8 deaths is due to air pollution. So what is it’s effect on cerebrova…
Radial head subluxation, more commonly known as nursemaid’s elbow, can be seen more frequently in the pediatric population. Imagine a parent quickly pulling a child’s arm (usually 1-4 years old) that was held in extension in ord…
It’s an intake shift and yet another person comes in saying, “I feel congested doc. I need antibiotics for sinusitis.” A recent Cochrane review published in September 2018 that included 15 trials involving 3057 patients re…
Should patients in septic shock get corticosteroids? A meta-analysis of 22 randomized clinical trials (RCTs) published in Intensive Care Medicine in July 2018 compared low-dose steroids vs placebo in adults in septic shock. It found that gi…
What is Sinai’s troponin assay? Answer: ARCHITECT STAT Troponin-I A Global Task Force with involvement from the American Heart Association (AHA), American College of Cardiology Foundation (ACCF), European Society of Cardiology (ESC),…
“I have a headache”….the number of times we as ED providers have taken care of a patient with this complaint is uncountable. Once we have established that the source of the headache is not life threatening we then move on…
So you’re working a busy resuscitation shift when you are alerted by the triage nurse of a possible stroke with onset approx 1 hour ago. You go assess the patient and you find a 75 yr old gentleman with left sided facial droop, slurre…
Per ACLS guidelines, stable ventricular tachycardia can be treated with either IV Amiodarone or IV Procainamide. Clinically it appears that Amiodarone has been the preferred agent, although both drugs have received a class II recommendation…
Tranexamic acid (TXA) is a synthetic anti-fibrinolytic agent used to treat many different bleeding complications. It’s implications in trauma as well as its various routes of administration including orally, IV, and topically have bee…
“The HgB has dropped, have you checked a guaic?” How many times have you checked a FOBT in your workup for anemia? Let’s take a look at what FOBT is supposed to be used for. FOBT is a visual stool assay in which heme in th…
During a busy day in the ED, it becomes apparent that the pulling and yanking on your patient’s shoulder has done absolutely nothing to reduce their shoulder. You perform your pre-procedure PSA Checklist, know that this young and acti…
You’re working in pediatrics, when a mother comes in stating her 5 year old has sinusitis. He presents with fever, cough, runny nose, and some discomfort over where his frontal sinuses are. Does he have sinusitis? Not so fast! The eth…
Over the past week, we’ve had a strange uptick in number of patients presenting to the ER with rings stuck on their finger. This is a quick review on the options that you have regarding how to remove them. Assuming your patient has tr…
So, you’re working in the ED when a new stroke code is activated. You walk over and see a young gentleman with the complaint of left facial tingling, right arm and leg weakness with some tingling. Overall though, a relatively w…