EM Mindset: Rob Orman – The Successful ED Mindset

We at emDocs are proud to introduce our new series called “EM Mindset.” We hope our audience enjoys the pearls of wisdom that each of these seasoned EM vets have to offer on developing the “EM Mindset.” In case you missed it, please check out the first post of this series by Bob Stuntz. Look out for “EM Mindset Mondays.” Enjoy!

Management of Cellulitis in the Immunocompromised Patient

Pearls and Pitfalls

Cellulitis that is associated with purulent drainage is commonly associated with Staphylococcus Aureus compared to non-purulent cellulitis that is more commonly β hemolytic streptococcus. Antimicrobial therapy should be directed at the organism in question.
Cellulitis may not appear as red and can span the gamut from pale to violet coloration in deeper infections. Pain is not always present particularly in immunocompromised patients.
Cultures from peripheral blood, needle aspirates, skin biopsies, and surgical specimens have a relatively low yield. They should be considered however in patients with purulent drainage, those who failed outpatient therapy, or immunocompromised patients.

Does IV contrast cause renal failure?

We hear about contrast-induced nephropathy all the time. We tell patients about it. We often need their consent. Radiology calls us to make sure administering contrast is okay.

But is it as bad as we think? How do we proceed?

Hypothermia and Drowning Pearls

Winter is coming…well maybe not yet, but you never know when you will see your next drowning or hypothermic patient will enter your ED, so be prepared! Check out the latest pearls on hypothermia and drowning!

Post-Tonsillectomy Hemorrhage

We know that all bleeding eventually stops: ideally, by means that we have imposed rather than by exhaustion of the patient’s RBC resources. We also know that the easiest, and often most efficacious, way to halt bleeding is to put some manual pressure on the source of bleeding. Well, that isn’t always so easy to accomplish. How do you put your finger on a bleeding tonsil?

Emergency Medicine Education