I don’t remember much of what happened that day. It was busy, an overwhelming state of chaos in an already overwhelming emergency department. I was called to the trauma bay— another medical resuscitation. She was 80. She was alone. We worked on... Continue Reading →
Caution in Pediatrics Important medico-legal issues -Recognize high risk cases (i.e. close contact with Neisseria meningitis) -Be wary of unexplained tachycardia! -Avoid discharge diagnoses of "viral syndrome" or "gastroenteritis." Use "fever" or "vomiting" instead. -Considering discharge? Double check, vitals, document.... Continue Reading →
EM – Critical Care Journal Club Topic: 'Lytics in Sub-massive PE - Part II Article: Chatterjee, Saurav, et al. "Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis." Jama 311.23 (2014). Resident: Thiago... Continue Reading →
EM – Critical Care Journal Club Topic: Thrombolysis for sub-massive pulmonary embolism (PE) Article: Konstantinides, S.V., et. al. Impact of Thrombolytic Therapy on the Long-Term Outcome of Intermediate-Risk Pulmonary Embolism. Journal of the American College of Cardiology. 2017. Volume 69,... Continue Reading →
Sickle Cell Disease Acute Complications -Sickle cell pain: Diagnosis of exclusion! -Fever: Patients are functionally asplenic, prone to sepsis. Give antibiotics. -Chest pain/dyspnea: Acute chest syndrome (leading cause of death), PE -Headache: CVA ischemic (children and older) or hemorrhagic -Abdominal... Continue Reading →
EM – Critical Care Journal Club Topic: Use of tenecteplase in patients with intermediate-risk pulmonary embolism Article: Meyer et al. "Fibrinolysis for Patients with Intermediate-Risk Pulmonary Embolism." NEJM 2014. Resident Reviewer: Emily Zametkin, MBBS Case / Problem Should we... Continue Reading →
Monday 3p-11p You Always Remember Your First Code Resident Photographer: Ted Mooncai, MD Faculty Editor: Elizabeth Mitchell, MD What do you think about these photos? Share your thoughts with us below.
Dosing the Turkey Sandwich: De-Escalation in the ED Categorizing Agitation 1) Agitated but cooperative 2) Disruptive without danger 3)Agitated delirium -Multiple ways to classify the increasingly agitated patient, pick one that works for your practice. -Consider having a step-wise treatment... Continue Reading →