Thyroid Storm Management

TR Pearl: Thyroid Storm Management Diagnosing Thyroid Storm:  Management Things to keep in mind For patients in thyroid storm or impending storm If thyroid storm for sure, add glucocorticoids. They reduce T4 to T3 conversion….

Asthma and Redlining

“Take a deep breath and hold it. Now without exhaling, try to breathe in again.” We were in the cardiac room, discussing a young man that had died a few hours before we came onto our shift. He had been brought in after he was found in the s…

TB in the ED

Tuberculosis in the ED Patient presents to Elmhurst ED with cough, hemoptysis, night sweats and fatigue – quick, what’s the first diagnosis that comes to mind? This is the classic presentation for tuberculosis. But several times now I…

Sickle Cell Disease Emergencies

Sickle cell disease affects ~ 100,000 people in the US. Though pain is the most common ED presentation for patients with SCD, we should always consider life-threatening emergencies in this devastating and complicated disease.  Acute Chest S…

Trauma in Pregnancy

Trauma is the leading cause of non-obstetric death in pregnant women. MVAs and intimate partner violence account for most cases.  Let’s first discuss the physiological changes to consider when managing a pregnant patient in a trauma. M…

Managing Expectations

Let’s talk about managing expectations. You can do this with almost everyone/everything in your life, your goal being to under sell, over deliver. Some, not all, patients think that when they walk through these hallowed doors, th…

Helmet Removal

Why should I care about this? Ok, so it may not be that interesting, however, we should still review how to responsibly remove a helmet. In NYC, we very rarely encounter injured patients with a helmet on and that’s probably because they wer…

POCUS guided LP

Intro Raise your hand if you ever struggled obtaining a CSF sample from a Lumbar Puncture. I “virtually” see that most if not all of you at one point in your career struggled with this. This pearl is inspired by an overnight Elmhurst A-side…

ECMO made EZ

Intro For this week’s teaching pearl, I wanted to go back and cover a medical pearl. We always hear the word “ECMO” thrown around but I want to today go into a very brief overview of what ECMO is and why it is being used more commonly. I am…

Pressors 101

By Lara Silverman, MD/MPH Emergency Medicine PGY3 Pressors are used in hypotension. Per Scott Weingart, there are three main reasons we use pressors:  Maintain critical perfusion pressors, especially to the brain, heart, and kidneys. B…