Myxedema coma, or severe hypothyroidism, is an emergent condition with a high mortality rate (30-60%). Our patients rely on us to catch it early and treat aggressively. About 90% of cases occur during the winter months, and it is rarely seen in patients younger than 60.   Causes: Myxedema coma is usually precipitated by another […]

In October 2016, the Pulmonary Embolism in Syncope Italian Trial (PESIT) was published in the New England Journal of Medicine. Since its publication, it has generated a great deal of conversation and controversy.   First, a brief rundown of the study: Its objective was to determine the prevalence of PE among patients older than 18 […]

Weaver LK, Hopkins RO, Chan KJ, et al. Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med. 2002 Oct 3;347(14):1057-67.   What we already know about the topic: Carbon monoxide poisoning is responsible for about 40,000 visits to emergency departments every year in the U.S. Patients who survive the initial insult are vulnerable […]

When we call our colleagues from ENT with a question about a patient’s tracheostomy, they’ll want to know what type of tube the patient has. Let’s go over two types:   Plastic Tubes Flexible plastic tubes (most common brand name is Shiley) are seen very commonly. They usually have an inner cannula and an outer […]

What happens when a patient’s pacemaker seems to be malfunctioning? “Call the EP fellow” should not be your only answer! Take a look at the ECG, and ask yourself if the pacemaker may be over-sensing, under-sensing, or failing to capture.   Over-sensing: The pacemaker is too sensitive. It interprets electric potentials that don’t come from […]