Resus SinaiEM Blog – Page 35

52 in 52 Article Review: The risk of catheter-related bloodstream infection with femoral venous catheter as compared to subclavian and internal jugular venous catheters

Posted on November 28, 2016 by Carl Mickman

Article Citation Marik PE, Flemmer M, Harrison W: The risk of catheter-related bloodstream infection with femoral venous catheter as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis. Crit Care Med. 2012, 40: 2479-2485. Resident Reviewer Carl Mickman Why this study is important Placing central venous catheters in […]

Wellness

Posted on November 18, 2016 by Leslie Pendery

At our wellness conference we talked about different strategies to manage burnout through gratitude, deep breathing exercises and story-telling. Today we will add another technique to our wellness arsenal: spending time in nature. In NYC, this may be difficult, but luckily we have multiple parks and green spaces throughout our city and Central Park is […]

52 in 52: Nasogastric tube in GI bleeds

Posted on November 17, 2016 by Leslie Pendery

Article Citation: Palamidessi N, Sinert R, Falzon L, Zehtabchi S. Nasogastric aspiration and lavage in emergency department patients with hematochezia or melena without hematemesis. Acad Emerg Med. 2010 Feb;17(2):126-32. PMID: 20370741 What we already know about the topic: Nasogastric aspiration and lavage for patients with melena or hematochezia to localize GI bleed is controversial. Supporters argue that […]

Ouch! My thumb!

Posted on November 14, 2016 by Leslie Pendery

A 44M with no PMH slipped and fell on his hand while playing with his kids in the park. He has swelling and pain over thumb MCP joint that is exacerbated by movement. The xray of his thumb is above, what is your diagnosis? This injury is known as skier’s thumb. The mechanism is a […]

Emergency Cricothyrotomy: A Review

Posted on November 11, 2016 by Leslie Pendery

We do a lot of life-saving procedures and interventions on a daily basis in the emergency room. However, there are some much less frequent but equally as important life-saving procedures we need to know how to do. Today we will review how to do an emergency cricothyrotomy. This procedure is indicated for those patients you […]

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Conjunctivitis In A Newborn

Posted on November 10, 2016 by Leslie Pendery

A mother brings her 4 day old newborn baby boy into the Peds ED for bilateral eye discharge. Mom tells you he was full-term and healthy, but she did not have prenatal care. The baby is well appearing and is eating, urinating and defecating well. A picture of his eyes are above, are you concerned? You […]

52 in 52: CRASH-2 Trial

Posted on November 8, 2016 by Leslie Pendery

Article Citation: CRASH-2 trial collaborators, Shakur H, Roberts I, Bautista R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3;376(9734):23-32. PMID: 20554319 What we already know about the topic: Traumatic injuries are a major cause of death […]

The Syringe Technique for TMJ Dislocations

Posted on November 7, 2016 by Leslie Pendery

Acute non-traumatic temporomandibular joint (TMJ) dislocations occur after extreme opening of the mouth (yawning, eating, laughing, singing or dental treatment. TMJ dislocation is when the anterior condyle moves too anteriorly and becomes locked in the eminence. This also results in stretching of ligaments and is associated with severe spasm that results in difficulty closing the mouth […]

The NYC Marathon and Heat Related Illnesses

Posted on November 4, 2016 by Leslie Pendery

The NYC Marathon is this Sunday! The city has been gifted with some unseasonably warm weather the past couple days, but this has the potential to cause problems for the thousands of runners. Today we will talk about heat exhaustion and stroke, which represents the most severe end of a spectrum of heat related illnesses. […]

Dermatologic Emergencies

Posted on November 3, 2016 by Leslie Pendery

Case: 40 year old male presenting with rash for one day. Patient recently started Bactrim, endorsing flu-like symptoms for the past 2 days. Chest and back are erythematous and warm. In the ED, patient is febrile and tachycardic. Based on the picture below what should you be worried about? Stevens-Johnson syndrome (SJS) and toxic epidermal […]

52 in 52: Ottawa Ankle Rules

Posted on November 1, 2016 by Leslie Pendery

Article Citation Stiell IG, Greenberg GH, McKnight RD, Nair RC, et al. Decision rules for the use of radiography in acute ankle injuries. Refinement and prospective validation. JAMA. 1993 Mar 3;269(9):1127-32. PMID 8433468 What we already know about the topic: Patients presenting with ankle injuries is a common occurrence in the emergency department, but less than 15% […]

Lunate and Perilunate dislocation

Posted on October 31, 2016 by Leslie Pendery

A 36F presenting with wrist pain after a fall on an outstretched hand. She has pain and swelling over the dorsal-radial aspect of her hand. Her xray is below, what is the diagnosis? It’s the spilled tea cup sign, but can you remember which dislocation it stands for?? It is the lunate dislocation. Both the […]

High Altitude Illnesses, part 2

Posted on October 28, 2016 by Leslie Pendery

Yesterday, we learned about acute mountain sickness (AMS) and high altitude cerebral edema (HACE). Today we will tackle high altitude pulmonary edema (HAPE), the deadliest of the altitude illnesses. HAPE generally occurs above 3000m, but incidence varies at different altitudes. At 4500m the incidence ranges from 0.2 to 6%. Factors that place people at increased […]

High Altitude Illnesses, part 1

Posted on October 27, 2016 by Leslie Pendery

While we may not see as many wilderness related injuries in the concrete jungle of NYC, they are important to know. Especially when you ski out west, tick off the bucket list item of trekking K2 or when it inevitable shows up on the boards. Today we will talk about acute mountain sickness (AMS) and […]

The 52 in 52 Review: The HEART score

Posted on October 25, 2016 by Leslie Pendery

Article citation: Backus BE, Six AJ, Kelder JC, Bosschaert MA, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013 Oct 3;168(3):2153-8. (Link to the article here) What we already know about the topic: Chest pain is one of the most common complaints in […]