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LA Peds Ready Podcast: Special Pathogens – Part 2

A critically ill infant arrives in respiratory failure, but a key exposure history raises concern for something beyond routine influenza. In Part 2 of our Special Pathogens series, we work through a suspected H5N1 avian influenza case, from initial stabilization and protecting the healthcare team to diagnostic testing, treatment, post-exposure prophylaxis, and coordination with public health.

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    Articles

    Wrist Injuries: Pearls and Pitfalls

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    Wrist pain is a frequent emergency department complaint. Most presentations are due to an acute traumatic injury. Furthermore, overuse or repetitive motion mechanisms cause ED visits for either an acute injury or an exacerbation of chronic pain conditions. For the purposes of this post, the wrist is going to be
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    • practice updates

    Naloxone in the News: Time to Address our Opioid Abuse Problem

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    Naloxone has been proven to reduce the incident of death in acute opioid overdoses. So why aren't we using it more often?
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    Thromboelastography (TEG®) for Trauma

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    Editor's note: This article was listed in LITFL Review 154's "Best of #FOAMcc Critical Care" section.

    Using thromboelastography in goal-oriented algorithms, clinicians may be able to optimize targeted transfusion therapies with specific coagulation factor(s) instead of empirically administering multiple components with potentially hazardous effects.

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    Bounceback: An Unrelenting Headache

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    CC: Headache First visit HPI: 29 year old female with a prior history of headaches, presented with two days of gradual onset, atraumatic, right sided headache that is throbbing in nature. The patient reported heaviness about the eye but no visual changes or disturbances. No neck pain, fevers, chills. She
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    • practice updates

    Don't be RASH: Emergency Physician's Approach to the Undifferentiated Lesion

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    Editor's note: This post was listed in both the #FOAMED Review from EM Curious AND in the LITFL Review 154 "Best of #FOAMed" section.

    As an EM physician, it is difficult to have working knowledge of the hundreds of different types of rashes that exist. However,

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    Left Bundle Branch Block in Myocardial Infarction: An Update

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    Editor's note: This article was listed in the LITFL Review 154's "Best of #FOAMed" section.

    The left bundle branch arises from the Bundle of His, and subsequently is divided into the anterior and posterior fascicles. The anterior fascicle is usually supplied by septal perforators from the Left Anterior

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    Acute heart failure exacerbation disposition

    Not all patients require admission

     

    Consider patient hemodynamics, respiratory status, ECG, labs (Cr, troponin, sodium/electrolytes), ability to ambulate, follow up

     

    Elevated troponin and serum Cr associated with worse outcomes

     

    Don’t use risk tools alone for DC, but Ottawa Heart Failure Risk Scale may assist in admission (ACEP Level B)

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