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Night School: ‘Roid Rant

By: Dr. Steve McGuire  Night School at the Old Boston City Hospital: ‘Roid Rant – On the ED use of Steroids.   There are only a few things I know about the world. Sunrise in the east, sunset in the west.... Continue Reading →

Emesis as Nemesis

By: Jordan Spector, MD Case Presentation You are an intern in the ED at BostonCityEM, and you encounter the following patient: 28 year old male with a history of mild asthma who presents to the ED with approximately 12 hours... Continue Reading →

An Approach to Access in Trauma Room Patients

By: Dan Resnick-Ault, MD At Boston City EM, tradition is alive and well in the resuscitation bays, where obtaining vascular access is delegated to a PGY-1 or 2 while an emergency medicine (EM) senior resident ‘runs’ the case (supervised by an... Continue Reading →

Palliative Care in the Emergency Department: Yes, We Can & Yes, We Should

By: Drs. Gips, Jaworski, and Zametkin Case: An 82 year-old female with a past medical history of HTN, DM, CAD and cardiomyopathy with multiple recent admissions presents with shortness of breath. The patient had been admitted one week prior, during which... Continue Reading →

SEP-1: Severe Sepsis by the Numbers

By: William Baker, MD THINK SEPSIS: SAVE LIVES Scope of the problem Approximately 1 million patients in the United States are affected by severe sepsis (SS) annually Most common cause of death among critically ill patients in non-coronary intensive care units (1)... Continue Reading →

Thoracic Trauma: Rib Fractures

By: Elizabeth Wallace, MD Broken Ribs? Who cares? Many trauma victims sustain injuries to their ribs, but these are an afterthought to the initial resuscitation. Providers correctly focus on the ABCs, along with major organ injury or extremity deformity, at the expense... Continue Reading →

Sepsis 1.0

By: William Baker, MD Sepsis pearls regarding the CMS bundle "SEP-1" Severe sepsis: (per SEP-1) All three within 6 hours of each other Documentation of a suspected infection (not just the dx) Two or more SIRS criteria Temperature >38.3 C or <36.0... Continue Reading →

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