In the ED we think a lot about pulmonary embolism, and thus decision rules, d-dimers and CTAs. Because we have a low threshold to test for PE, we spend a fair amount of time trying to not get that CTA. There are a number of tools to risk stratify, but we commonly turn to Wells’, […]

We’ve all seen the patients roll in with EMS nasal cannula snug against their nares. “Why are they on oxygen?” EMS response, “I don’t know he was having chest pain.” EKG shows STEMI! The last thing you’re thinking is whether their nasal cannula should be adjusted but maybe they don’t need the oxygen at all. […]

Seeing our alumni at ACEP was amazing! It seems like Life after Residency is sweet: making your own schedule, working with great colleagues, no more pushing people to CT, developing startups! The sky is the limit but then there’s the inevitable question, the question that lurks in the back of my mind since days of […]

Overdose and EKGs they start to all look the same…widened QRS, that thing in aVR…vfib (hopefully not). Here’s a highlight of key EKG findings associated with a few toxidromes: (1) Bupropion overdose (2) TCA overdose (3) Digoxin Toxicity Bupropion Overdose: See wide-complex tachydysrhythmias-widened QRS and QT intervals; case reports have shown cardiogenic shock Consider in […]

Dr. David Forsh’s review yesterday of compartment syndrome made me realize how rarely we see this life-threatening diagnosis. So what do we need to know? What’s the etiology of compartment syndrome? Majority cases 2/2 Fractures (75%); the rest are soft tissue injuries from causes such as: snake bites, seizures, burns, tourniquets,… People with coagulopathy such […]