Sickle Cell Disease Emergencies

Sickle cell disease affects ~ 100,000 people in the US. Though pain is the most common ED presentation for patients with SCD, we should always consider life-threatening emergencies in this devastating and complicated disease.  Acute Chest S…

Pressors 101

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. B…

Tap that? VP Shunts & their complications

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. 

Dripping in that Sedation

Today’s pearl: SEDATION DRIPS Titrating the sedation regimen on the sickest of patients can be one of the most challenging parts of the MICU. Anecdotally, many COVID+ vented patients in particular need at least 2, sometimes 3 diff…

Calcium Channel Overdose

For those who could not make it to VMR, we went over a truly sick calcium channel blocker overdose case. If not, here’s a quick rundown, and a link to the slides.   Briefly, the case was a 17-year-old female who reportedly overdosed on 60 m…

Blood on the Dance Floor

We’ve all seen that movie where some old person coughs into a handkerchief and as the camera slowly pans away, there’s some blood stain. You know that guy isn’t making it to the end of the movie… Today, let’s t…

ED Intubation Checklist

In addition to his love of ketamine and proper PSA technique, Reuben Strayer has written and talked extensively about ED intubations. Here is his checklist so that you can minimize complications and maximize your success: For more informati…

To “B” or not to “B”

An Ode to Bougie Written by Paul Johnston So what’s a bougie?  If you already know, skip this paragraph.  A bougie is a flexible rod used to aid intubations. During a “conventional” intubation an ET tube w…

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…

October 2023