Dopesick

Opioids and why Written by Erena Weathers Case: you have someone who broke their leg doing a ~*~sick~*~ skateboard trick. They stuck the landing, and their tib-fib snapped. They’re ready to be discharged and you feel like the good ‘ol Tylenol/Motrin won’t be enough to get them through the next couple of days. You decided […]

VBG a brief guide

But what is the pH? Written by Erena Weathers Per direct request: “Some people can just look at a VBG and know what’s going on. I want to be able to do that!” First, big ups to Dr. Hashem Zikry of “Runs Really Fast” Fame (2:32:51 2018 NYC Marathon time) for his TR pearl of how you can […]

Puff Puff Pass the Ketamine

Nebulized Ketamine for Pain Written by Erena Weathers Dear ketamine enthusiastsEver wonder why there aren’t more ways to give your patient this wonderful drug? Well here’s one more route of administration that is easy and clinically relevant. You know about IV and IM, but did you know you can nebulize ketamine for therapeutic benefit?  Drapkin […]

A Shocking Idea

Septic Shock and you want me to give Esmolol? Written by Erena Weathers Today’s pearl is a fun one, and one it seems not many have heard about. It is the idea in septic shock you can give esmolol to improve mortality.  “But Erena, we need pressors in shock and now you’re telling me we are going […]

RUSH

It is now the standard of care to perform focused assessment using sonography for trauma (FAST) early in the evaluation of a sick trauma patient. Historically, there has been far less urgency to use ultrasound to evaluate the medical patient with hypotension or signs of shock. One reason for this discrepancy is the lack of […]

Hair Apposition

A HAT (Hair Apposition Technique) Trick Written by Mike Barsky Lacerations are one of the most common reasons patients present to the ED. Most lacerations require primary closure to avoid infection and achieve a functional and aesthetically pleasing scar. Patients want a repair that is quick, painless, cheap, w/ a low infection rate and minimal […]

Why Syphi-Less when you can Syphi-MORE?

Syphilis Written by Erena Weathers What is syphilis? It is an infection caused by the bacterium Treponema pallidum, a spirochete, with an internal flagella. You may know it as the GREAT IMITATOR  but it is also known as the GREAT POX (and that is why smallpox is called smallpox, because syphilis took the title of the great pox). It is spread […]

MSH Consent Forms

General Consent to Surgery/Procedure/Treatment/Anesthesia (Spanish) Consent to Transfusion (Spanish) AMA (Spanish) Medical Order for Life-Sustaining Treatment (MOLST) NYC Healthcare Proxy Form (Spanish) MRI Screening Form (Spanish) MICU Transfer Form (Pilot) DNR: Adult with capacity DNR: Adult therapeutic exception DNR: Adult without capacity who previously consented to a DNR order DNR: Adult without capacity and with […]

What order of operations?

Cefepime + Vanc > Vanc + Cefepime Written by Erena Weathers So you’re in Resus, your very first one. Leibner is yelling, triage is yelling, and your sphincters are *tight*. Suddenly a nurse comes asking about your elderly septic patient, “hey, what do you want to start?” You have heard all-stars like Dr. Spadafore or […]