NGT INSERTION

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 placement.     SUPPLIES cup of water with a straw emesis basin […]

No, that’s not an olive. That’s Pyloric Stenosis!

Inspired by what appears to have been a very interesting day in the Peds ED, lets review a rare but interesting pediatric entity: PYLORIC STENOSIS Background: MC in Males (5:1) & firstborn children (30%) Usually begin between 3-6 wks of age, rarely after 12 wks Clinical Presentation: Nonbilious emesis. Early, patient will be hungry and […]

Ouch that monkey bit me!

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, primarily occurring in India or research labs. They have a high rate […]

It’s Freezing!

You are at elmhurst in the cardiac room. It is FREEZING outside. The triage nurse tells you there is a frequent flier in triage, EMS found him sleeping on the street with +AOB. He is confused and moaning to sternal rub. They cannot get an oral temp and they cannot find the rectal probe, but […]

pediatric blood transfusion

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. The transfusion volume is usually 10 to 15 mL/kg. Infants […]

Spontaneous Pneumomediastinum

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 pneumomediastinum is rare, occurring in approximately 1 in 30,000 […]

In flight emergencies and when to land the plane

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 announcement interrupts your zen-like, screen-induced partial stupor.  “Is there a doctor on board?” […]

PE risk stratification: which tool is best?

  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 help you decide? Up until recently, there were no prospective studies […]

Proper cane use

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 greater risk of falls.   The proper height can be […]

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