Locate the best site for needle insertion, demonstrate the appropriate angle of insertion, and measure the distance to reach the subarachnoid space.

The things you need to know about MERS...

For your Friday afternoon, here's another batch of excellent write-ups from the EM interns at UT Southwestern. Our ongoing intern report series is the product of first-year residents exploring clinical questions they have found to be particularly intriguing, with an intended audience of med students & junior residents. Enjoy! [Note: These are PDF files.]

• CHF Exacerbation by Meaghan Dehning, MD
• Use of Ultrasound in Endotracheal Intubation by Andrew Fredericks, MD
• Ventilator Strategy for an Acute COPD Exacerbation by Andrew Fredericks, MD
• Wernicke's Encephalopathy by Richard Moleno, DO; edited by Larissa Velez, MD
• Serotonin Syndrome by Andrew Fredericks, MD; edited by Larissa Velez, MD
• Steroids for Sciatica by Christina Smith, MD
• Post-Partum Fever by Meaghan Dehning, MD
• Pressor Choice In Shock by Chris Chase, MD
• Procedural Sedation in the ED by Chris Chase, MD
• RSI Pharmocology for the EM Physician by Richard B. Moleno, DO
• Management of Traumatic Subungual Hematoma by Lindsay Schroeder, MD
• Leukocytosis in the Immunocompromised by John R. Corker, MD
• H&P for Ovarian Torsion by Gray Millsap, MD
• Pericarditis by Ashley Phipps, MD
• Estrogen for Uterine Bleeding by John R. Corker, MD
• Treatment of Intractable Hiccups by Ashley Phipps, MD
• Central Venous Access Site Comparisonby Kevan Beth Meadors, MD
• COPD Exacerbations and Managementby Stace Breland, D.O.
• Epistaxis by by Gray Millsap, MD
• Energy Drink Toxicityby Kevan Beth Meadors, MD
• Delayed Neuro Injury Following Electrocution: Two Case Reports by Brandon Morshedi, MD
• Compartment Syndrome by Alex Cohen, MD
• Appy In Pregnancy by Christina Smith, MD
• Benzo Resistant Alcohol Withdrawal Seizures by William Fox, MD, edited by Larissa Velez, MD
• Benzodiazepines in Alcohol Withdrawal Syndrome: Preventing “Kindling” by William Fox, MD, edited by Larissa Velez, MD
• APAP Overdose by Alex Cohen, MD

It’s a typical busy afternoon ED shift for you. The rack seems to be overflowing, and 3 new patients have just checked in. All have abdominal pain. You have a systematic approach to your abdominal pain patients. But, does your approach keep one critical diagnosis in mind? [...]

[Editor's note: For a limited time, Tintinalli's is making their full chapter entitled "Chest Pain: Cardiac or Not?" available to emDocs readers.]

Our AMA with Dr. Mike Mallin & Dr. Matt Dawson from the Ultrasound Podcast, held on Friday, November 14th from 2-3:30pm EST.

These children are often a mixed picture of viral bronchitis/bronchiolitis PLUS an asthma exacerbation. Treatment with albuterol, ipratropium, magnesium sulfate, steroids, fluids, etc are all reasonable and prudent in this population. If they begin to clinically improve within 30 minutes then you can feel good about soothing their reactive airways. However, they still have underlying viral issues which may require non-invasive positive pressure ventilation (either high-flow nasal cannula or BIPAP). If they do not improve within 30 minutes then you should begin to plan for IMC/ICU admission as these patients will require significant monitoring and respiratory support.

Trying to predict the future is a task that is riddled with risk. There is a very high potential that I will be wrong and my thoughts will end up being complete baloney. I'm okay with this. According to Strengths Finder 2.0, I'm futuristic, meaning that I'm inspired by the future and what could be, and hopefully will inspire you. With this in mind, two quotes that I believe should frame our conversation: "The future is already here, it's just not very evenly distributed." -William Gibson "We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next 10." -Bill Gates With these in mind, here are some trends that I see emerging. [...]