Quick Hit – Femoral Central Lines
By Duncan Grossman, DO
Quick Hit – Bougie
By Duncan Grossman, DO
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””
Lisfranc injuries
Quick Review of Lisfranc Injuries Lisfranc injures are a spectrum which result in a sprain or complete disruption of the tarsometatarsal joints of the midfoot. They most commonly occur at the base of the 2nd metatarsal with oftentimes subtle or even absent findings on standards x-ray views, especially when they result from low velocity injury. What is mechanism of …
Blunt chest trauma
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?
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.
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 …
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 …
Top 10 Infectious Disease Updates
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!
Stressed vs unstressed volume
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.
Top 10 Eye Emergency Pearls
Always screen patient for an Afferent Pupillary Defect (APD)! A negative Seidel Test does not rule out a Globe rupture Avoid NSAIDS and aspirin in Hyphemas and Globe Rupture CT Scan of the Orbit is only 56-68% sensitive for identifying a Globe Rupture, so don’t solely rely on it for the diagnosis! Order a Sickle …