Quick Hit – Femoral Central Lines
By Duncan Grossman, DO
Quick Hit – Bougie
By Duncan Grossman, DO
Antibiotics for chest tubes
If you are cutting into someone’s chest to put a tube in it, should they get presumptive antibiotics? Check this out
Bronchiolitis!
Not much gets more exciting than bronchiolitis! Check out this quick review of the quick hitting points
Case of the Week #1
Our inaugural first Case of the Week is brought to you by Dr. Kristen Pena with a tricky EKG case!
Recent Pubs
We’ve had a bunch of publications in both peer-reviewed and non peer-reviewed sources over the past few weeks! Check them out when you get a chance: Traficante and Kashani in the Journal of Clinical Toxicology talking about a Massive Calcium Channel Blocker OD McGovern and D’Amore in Annals of Emergency Medicine talking about Peds EM …
Just because she cannot pee, does not mean “No UCG”
Let’s face it, we’ve all done it. And, believe me when I tell you all the cool cats are doing it, too. Of course, I am referring to the use of whole blood to determine a woman’s pregnancy status in the Emergency Department using the urine pregnancy test strip. Did you know that the common …
Read more “Just because she cannot pee, does not mean “No UCG””
Tox Box Journal Club
In this installment of the Tox Box Journal Club we are going over three articles reviewed at the NYC Poison Control Center in Manhattan last week. Two of the articles discuss utility of lipid emulsion therapy in animal models and a third on the deleterious effects of methotrexate dosing errors in Australia.
Fat embolism syndrome
Typically when we start talking about anything related to fat embolisms our minds go immediately to trauma and long bone fractures as the cause, but this isn’t always the case. The constellation of signs and symptoms of respiratory insufficiency, neurologic dysfunction and petechial rash which are typically associated with fat embolism syndrome can also be caused by pancreatitis, sickle cell disease and liposuction; all of which show up regularly in the Emergency Department. With mortality rates as high as 20%, despite the fact that FES usually doesn’t present for at least 12 hours after the initial event, it should be something that we are aware of.
Time for Terlipressin?
Correct, we don’t have terlipressin in the US, yet… Hopefully, sometime in the not so far off future we’ll have the chance to play around with it. Essentially it’s a synthetic analog of vasopressin which we are more familiar with. There’s some written about its use in variceal bleeds and here is a cool little study from Egypt using it for refractory septic shock.
Endophthal….what?
It’s difficult to miss a raging STEMI or a CVA with unilateral flaccid paralysis, but there are other, less-sexy diagnoses that we have the opportunity to make in the Emergency Department that can be as important and impactful to the patient’s health. Endophthalmitis is a difficult word to spell and equally as difficult to diagnose if you’re not …
Fixed dose PCC?
In the past, vitamin K and FFP were the mainstays of reversing warfarin, but now we have fancy new drugs like four-factor prothrombin complex concentrate (4F-PCCs). 4F-PCCs can rapidly reverse the INR of warfarin induced coagulopathy with less volume and quicker than FFP. Many of the dosing regimens base the dose on the patient’s presenting …
BOGO on TOAs
Lower abdominal pain in women can be challenging diagnostic dilemma in the Emergency Department. We had a case of a 50-year-old woman that had been previously seen by her PMD 3 days prior and diagnosed with a “small kidney stone” without any imaging, but did get the ever-reliable percocet prescription. Needless to say, she came …
Abdominal CPR?
There was a case report published in the Western Journal of Emergency Medicine last year about interposed abdominal compression CPR (IAC-CPR). Personally, I’ve never heard anything of the sort and had to take a deeper look into it. Essentially, you need two people to do compressions, one for the chest and one for the abdomen. …
When kids eat coins
Kids eat up your money in more ways than one. Some may eat it up in the form of $50,000 a year in college tuition and some eat it up as a meal. For coins that get stuck in the esophagus the American Society for Gastrointestinal Endoscopy recommends watching asymptomatic patients for a period of …