recent articles

practice updates

Lyceum Bullets: Trauma

Questions addressed by EM Lyceum and bulleted by emDocs: 1. When do you use tranexamic acid in trauma? 2. When you can’t get peripheral access in a trauma patient, do you prefer subclavian, femoral, or IO? 3. Which trauma patients do you give PCC to over FFP? 4. In blunt abdominal/flank trauma, do you send a urinalysis or simply look for gross hematuria?

practice updates

Stress testing: a beginner’s guide

Stress testing: a beginner’s guide Author: Jason Brown, Capt, USAF, MD (EM Resident Physician, University of Maryland) // Editor: Alex Koyfman, MD Stress tests are aptly named in that the goal is to cause a physiologic stress and to, through a variety of modalities, detect that stress’ impact on the myocardium. There are three major […]

practice updates

Posterior Stroke, HiNTS exam

Author: Jason Brown, MD (EM Resident Physician, University of Maryland) // Editor: Alex Koyfman, MD Background Posterior strokes make up 1 in every 5 ischemic strokes in the US.  That equates to about 150,000 strokes per year involving the posterior circulation with an incidence of 18/100,000.  Bottom line: This is a common, emergent diagnosis that […]


Nephrolithiasis: Diagnosis and Management in the ED

Authors: Subhanir Sunil Chitnis, MD (@ChitnisMD, EM Resident Physician, Rutgers NJMS), Dawn Kabba, MD (EM Resident Physician, Rutgers NJMS), and Miriam Kulkarni, MD (EM Attending Physician, Rutgers NJMS) // Edited by: Alex Koyfman, MD & Justin Bright, MD Introduction Calcium oxalate (and to some degree calcium phosphate) stones account for 80% of all kidney stones […]

practice updates

Management of Acute Respiratory Distress in a Tracheostomy Patient

Scenario: You receive a call from EMS stating they are on the way to your emergency department with a 60 year-old male in acute respiratory distress. VS: HR 105, RR 30, BP 126/68, SpO2 83%. No further information is provided. The patient arrives, awake, alert and oriented in visible respiratory distress and to your surprise has a tracheostomy in place! How does this change your management? [...]