recent articles

em@3am

EM@3AM: Methemoglobinemia

A 42-year-old female with a past medical history of iron deficiency anemia presents to the ED with a peritonsillar abscess. You give 2 benzocaine sprays and successfully aspirate the abscess. As she is waiting for her discharge paperwork, the nurse alerts you that her oxygen saturation is now in the mid-80s. Repeat vitals in the room are as follows: BP 102/78, HR 102, O2 85%, RR 24. She has perioral cyanosis that was not seen on your initial exam. What is the diagnosis and best next step?

TOXCards

ToxCard: Paraquat Toxicity

Paraquat is a herbicide that is rapidly absorbed and undergoes redox-cycling with generation of ROS causing cellular dysfunction and death. Tolerate hypoxia and avoid oxygen as it can promote oxidative stress and causes further tissue damage.

In the Literature

Journal Feed Weekly Wrap-Up

Journal Feed brings you three critical care articles evaluating high-flow nasal cannula for oxygenation, fluid overload and ICU mortality, and mechanical ventilation with low tidal volume in the ED.

Ultrasound G.E.L.

Ultrasound G.E.L. – The RUSH Exam in Polytrauma

The RUSH exam is a family favorite. It's a reliably easy to recall hypotensive protocol that uses ultrasound to help determine the etiology of a patient's shock. Well here's a new idea - trauma patient's can be in shock too, right? So maybe we should perform a full RUSH exam instead of just a measly EFAST? Well...hold your horses there kiddo, there may be more to think about with this one.