recent articles

practice updates

Push-Dose Pressors

"Despite the multitude of studies, the excellent results, and the commonplace use by anesthesiologists for decades, the use of push-dose pressors has not yet made its way into standard emergency medicine practice"
For a patient in shock, or with anticipated instability during procedural sedation, push-dose pressors can be a lifesaver. Brendon Browning, DO covers administration of pressors under circumstances in which central lines and infusions either aren't available or aren't needed.

Peds EM Morsels

Rapid MRI for VP Shunt Evaluation

"Patients with hydrocephalus will have nearly 4 scans per year during childhood"

For evaluation of VP shunts in children, the cost and study duration a rapid MRI is closer to CT than you might think (and without the ionizing radiation!). Best of all, the evidence comes from studies performed with populations chiefly less than 5 years of age. In this article, Sean M. Fox, MD makes a strong argument about why rapid MRIs should be a part of your institution's protocol.

practice updates

Wellens’ Syndrome

"One of the essential instant recognition abnormalities on ECG"
Knowing how to spot Wellens' morphology is crucial, but knowing when to expect those ECG changes is the other half of the battle. In this excellent article, Brendon Browning, DO covers the intricacies of this deadly entity, including diagnostic criteria, management pitfalls, and how to identify mimics.

practice updates

Dengue Fever

"Hundreds of thousands of cases of hemorrhagic fever yearly"

Kyle Brown, MD discusses dengue (aka "breakbone") fever in this detailed review, including characteristics of high-risk patients, criteria for making the diagnosis clinically, and current treatment recommendations.

practice updates

Ventricular Assist Device Management

"Some will not have a palpable pulse, and unfortunately, manual BP cannot be obtained. In addition, pulse oximetry is unreliable"

No pulse? No problem! Manpreet Singh, MD covers a stepwise approach to troubleshooting ventricular assist device complications in the emergency department.

practice updates

Blast Injuries

"The clinical picture is a mix of ARDS and air embolism"

Zara Mathews, MD covers the subject of blast injuries, including a review of the basics, important updates in the workup of these patients (for example, tympanic membrane rupture is not a great predictor of injury), and common pitfalls in management.