Boston City EM



Conference Learning 1.24.18

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 →

Conference Learning 1.17.18

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 →

Conference Learning 12.6.17

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 →

Conference Learning 10.11.17

By: Tom Gill, MD  Hematologic Emergencies: Lecture by Shayna Sarosiek, MD   Disseminated intravascular coagulation (DIC) -Causes: Many...infection, inflammation, malignancy, toxins, liver dysfunction -Microvascular thrombus most common -Work up: Platelets, INR, D-dimer, fibrinogen, PTT -Treatment: Cryoglobulin (if low fibrinogen), FFP (if bleeding), other... Continue Reading →

Conference Learning 11.4.17

By: Jeffrey Rixe, MD One Minute Neuro Exam of the Hand Median Nerve (OK) -Sensory: test 2nd digit light touch -Motor: thenar muscles, thumb pincer grasp, form the "OK" sign -Injury: supracondylar fracture, laceration near flexor retinaculum, carpal tunnel syndrome... Continue Reading →

Conference Learning 11.30.16

By: Jeffrey Rixe, MD Knee Dislocation -Tibio-femoral dislocation (50% anterior, hyperextension) (25% posterior, high impact mechanism) -40% popliteal artery injury -25% peroneal nerve injury -"Dimple" Sign: medial condyle of femur stuck in joint capsule (needs OR reduction) -50% self reduction.... Continue Reading →

Conference Learning 11.16.16

By: Jeffrey Rixe, MD Chest Trauma Rib Fractures - Chest XR: look for intra-thoracic trauma (no specific rib series indicated) - Multiple areas of tenderness? Consider CT - Flail chest: 3 or more rib fractures at 2 points. Flail segment... Continue Reading →

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