Anthony Catapano – Page 7 – St. Joseph's Health Center: Emergency Medicine Residency Program

ALTO at it again

by Anthony CatapanoNews, Silk City Blog September 1, 2016April 16, 2021Comments are Disabled

The ALTO program (Alternatives to Opioids) at St. Joe’s has already received national recognition for its work here. In March we held a legislative summit that was attended by U.S. Senators Bob Menendez, Cory Booker, US Congressman Bill Pascrell, Jr and multiple other members of the local and state government to discuss the opioid epidemic and the ALTO initiative. Then we were lucky enough to have the New York Times write a story recent story in June on the ALTO program as well. Not to be outdone, EM Resident recently published a piece to introduce the EMRA readers to the wonders of ALTO and the success we have had thus far with the program, check it out here.

Digoxin abortion gone awry….or did it?

by Anthony CatapanoOB/GYN, Silk City Blog, The Tox Box August 20, 2016April 16, 2021Comments are Disabled

Emergency medicine has to be one of the most diverse fields of medicine out there. Each day is a whirlwind of activity and patients, ranging from cardiac arrests down to the broken fingernail. Not only are we responsible for the most critically ill, the walking wounded and the patients that have nowhere else to go, but also are faced with the complications encountered in the outpatient setting. This could be a patient fresh from the chiropractor that is having neck pain, can’t move their arm and now have a carotid dissection; or a patient from a outpatient surgi-center that had local anesthesia but is now seizing; or in the case below a patient that underwent an elective abortion and now is hypotensive and bradycardic.

Lunate and perilunate dislocations

by Anthony CatapanoOrthopedics, Silk City Blog, Trauma August 8, 2016April 16, 2021Comments are Disabled

A weekend warrior trying to finish up painting that last side of the house takes a tumble off his ladder and lands on his left hand. He has a palpable deformity on the volar aspect of the distal radius and painful active and passive ROM but is otherwise neurovascularly intact with no median nerve neuropathy. The …

Throwin’ shade at the POKER Trial

by Anthony CatapanoAirway, Procedures, Silk City Blog August 3, 2016April 16, 2021Comments are Disabled

There’s been a lot of chatter in the twitterverse surrounding the recent release of the POKER Trial out of Australia comparing ketofol with propofol for procedural sedation. Their primary outcomes were looking at respiratory complications, including apnea, desaturation or hypoventilation; with secondary outcomes of hypotension and patient satisfaction. They report “ketofol and propofol resulted in a …

Blunt chest trauma

by Anthony CatapanoCardiology, Silk City Blog, Trauma August 1, 2016April 16, 2021Comments are Disabled

Being in a car accident, even the most benign one imaginable, can be stressful for patients. Inherently, if they have any chest pain they’re going to be convinced they’ve sheared their aorta right off its hinges. While that may be of concern to them, we are pretty certain that their aorta is still intact if they still are alive, but did they sustain a cardiac contusion? How do we even figure out if they had one? And what the heck do we do with them if they did in fact have a cardiac contusion?

Brain pus

by Anthony CatapanoCritical Care, Infectious Disease, Neuro, Sepsis, Silk City Blog July 28, 2016April 16, 2021Comments are Disabled

Having pus in your brain is a problem no matter how you cut it, but finding it in there can be a challenge. While the classic triad is usually fever, headache and a focal neuro deficit, this isn’t always present. Dave Traficante (@davetraf) just published a pretty cool case of bifrontal brain abscesses in the International Journal of Emergency Medicine of a gentlemen with this very problem. Interestingly, he didn’t have any focal neuro deficits, but he did have a very flat affect and could care less of the pus accumulating in his brain which coincided with the frontal lobe location of his abscesses.

Tox Box Journal Club

by Anthony CatapanoJournal Club, Silk City Blog, The Tox Box July 5, 2016April 16, 2021Comments are Disabled

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.

Gone fishin’

by Anthony CatapanoProcedures, Silk City Blog, Trauma June 23, 2016April 16, 2021Comments are Disabled

The weather is finally starting to warm up and the fish are biting. Unfortunately, amateur and pro fishermen alike will also either catch themselves or their friend while out on the waterways this summer. While a small fishhook lodged in a finger may seem trivial compared to some of the more traumatic injuries we see, …

Fat embolism syndrome

by Anthony CatapanoOrthopedics, Silk City Blog, Trauma June 10, 2016April 16, 2021Comments are Disabled

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?

by Anthony CatapanoCritical Care, Sepsis, Silk City Blog June 7, 2016April 16, 2021Comments are Disabled

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?

by Anthony CatapanoOphthalmology, Silk City Blog May 28, 2016April 16, 2021Comments are Disabled

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?

by Anthony CatapanoCritical Care, Silk City Blog May 14, 2016April 16, 2021Comments are Disabled

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

by Anthony CatapanoInfectious Disease, OB/GYN, Silk City Blog May 10, 2016April 16, 2021Comments are Disabled

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?

by Anthony CatapanoCardiology, Critical Care, Silk City Blog April 28, 2016April 16, 2021Comments are Disabled

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. …

Octreotide for sulfonylurea poisoning

by Anthony CatapanoSilk City Blog, The Tox Box April 26, 2016April 16, 2021Comments are Disabled

Newer second generation sulfonylureas are used extensively for treating type-2 diabetes mellitus (i.e. glyburide, glipizide, glimepiride and gliclazide). They are rapidly absorbed and reach peak plasma concentration typically within 2-4 hours; and have a duration of action up to 24 hours long. In 2010, the American Association of Poison Control centers reported nearly 4,000 cases …