Adrenal Crisis, by Dr Nilesh Patel -Also known as acute adrenal insufficiency or Addisonian crisis -No universally accepted definition. Proposed Definition: Acute deterioration in health status associated with hypotension (SBP < 100) or relative hypotension (drop in 20 mmHg from baseline) that resolve in 1-2 hours after glucocorticoid therapy. Generally this occurs in patients with …
Check out this month’s Pediatric Pearls on Bronchiolitis brought to you by our own Dr. Hima Khamar PGY-2!
Check out Take Home PEARLS from this week’s Wednesday EM Conference! Topics include Asthma/COPD, Sepsis, and mgmt of hemoptysis.
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.
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.
I recently gave an “ID Updates” lecture at AAEM’s Scientific Assembly in Las Vegas, February 2016. Here are the top 10 pearls from my lecture. Some may be review, some more cutting edge. Enjoy!
Dr. Rory Spiegel, from EMNerd, wrote a recent piece in Clinical and Experimental Emergency Medicine about how our undying love for left ventricular function in shock patients is perhaps overdoing it and the focus should rather be on the venous return.