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Intro I am going to switch it up and give a TR pearl on a “hidden curriculum” skill – How to deliver effective feedback. This is loosely based on an EMRA Education Committee feedback workshop that we held at ACEP. Feedback is an essential part of any professional field but can be challenging to provide […]
Intro Case Introduction: You are the overnight Peds EM resident and at 3 o’clock in the morning you get a notification (~5 minutes away) that a 4 month old boy with a hx of Tetralogy of Fallot who is awaiting elective repair is coming in appearing severely cyanotic, crying loudly, and hypoxic to ~40%. After […]
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. Below a MAP of ~50, a person will begin to have altered mental status and below ~40, the brain starts to […]
Lara Silverman MD/MPH, Emergency Medicine PGY3 Dizziness is vague, subjective, and the differential is literally everything from “you’re drunk go home” to life-threatening. Classically, we’re taught that dizziness is separated into 4 categories: vertigo (“room-spinning”), presyncope (“lightheadedness”), disequilibrium (“I feel unbalanced”), and non-specific / other. However, placing a patient in one of these categories relies on a patient’s subjective description […]
Conference Summary: October 5th, 2022Psychiatry Day Complied by Lara Silverman MD/MPH, Emergency Medicine PGY3 Alcohol Withdrawal with Dr. Olmedo Intro: The lecture starts with a story about “Jack, who had been drinking for 78 days” and then suddenly stopped drinking. Within 12 hours of his last drink, he became weak, sweaty, nauseous, tremulous, and started having […]
By Lara Silverman MD/MPH, Emergency Medicine PGY3October 2, 2022 Intro: Turns out most things in medicine are about acid-base disorders. A vent, understanding sepsis, kidney failure, respiratory failure, toxicology: so much of diagnosis and management alike comes down to acid-base. And while we’re not going to talk too much about equations, most of that stuff […]
By Lara Silverman MD/MPH, Emergency Medicine PGY3October 9, 2022 Intro: Let’s talk about the B-side. The B-side can be a hard and scary place to work for many reasons. Not only are patients agitated or altered, but they also have a high likelihood of trauma and often have chronic disease at baseline. I once had […]
Intro For the first pearl during our reign, I wanted to teach about the most dangerous thing I could think of. Hiccups. There are some dangerous etiologies out there so stay tuned. TR Pearls – <5 minutes – Often benign and self-limiting, but if persistent may be due to a medication, GERD, stroke, ACS or […]
tl;dr (<5 minutes) Quantitative end tidal: Partial pressure of CO2 in the gas sample at the end of expiration. You get a numeric value and a wave-form. EtCO2 is typically lower than PaCO2 due to anatomical and pathological dead space. Normal EtCO2 range is about 35-40 mmHg. Role in Intubation: End tidal is used as […]
Intro: Stroke is the third leading cause of death and number one cause of disability in the United States. Classically, strokes present with sudden onset focal neurological deficits in a vascular distribution and need prompt assessment and management to re-establish blood flow and avoid brain damage. However, the diagnosis of stroke is not always straightforward. […]
Intro You are working a BNT shift at Elmhurst and you pick up a patient who is complaining of neck pain after a fall. Do they need to be in a c-collar? Should you order a CT c-spine? What are the unstable c-spine injuries you are looking for? Shout out to Rozy for trying to […]
Is this monkeypox? But…what is monkeypox and what does it look like? What else should I consider on my differential? Is there a treatment? What do I do to treat it?
CSF shunts – these are the most common pediatric neurosurgery procedure done in the United States. While very common, these also have the highest rate of neurosurgical complications. About 50% fail within the first year, and the median survival of a shunt is usually 8-10 years, so a patient can expect 2-3 shunt revisions over the course of 20 years.
tl;dr – Story Time (<5 minutes) Patient is a 59 year old MTF with a PMH of HIV (undetectable viral load) and HTN (on amlodipine) BIBEMS for evaluation of “pinching” chest pain and right flank pain. EKG in triage revealed sinus bradycardia – HR 55 with a BP 130/70s. Patient was well appearing, endorsed chest […]
