On first glance, you observe active bleeding from the bilateral nares. Direct pressure has obtained hemostasis.
What is your next step? Topical vasoconstrictors? Nasal packing? Can this patient go home, or does he need to be admitted?
Let’s discuss a few key points about the management of posterior epistaxis.
The Emergency Department Management of Posterior Epistaxis Read More »
A hemothorax most commonly occurs secondary to penetrating or blunt chest wall trauma, with up to 70-80% of hemothoraces due to motor vehicle collisions. These injuries can cause rapid decompensation, but diagnosis and management isn’t always easy. This post is filled with pearls and pitfalls in diagnosis and management of massive hemothorax.
Managing a Massive Hemothorax: A Guide to Stabilizing Your Patient Read More »
All dialysis patients require some form of vascular access and unfortunately, complications such as bleeding may occur. This is a brief overview of the bleeding complications that may occur in the dialysis patient. Patient evaluation, workup and treatment regimens are discussed.
The Dialysis Patient: Managing Fistula Complications in the Emergency Department Read More »
Diagnosing seizures in young children can be difficult and even more so in those under the age of one year. This is a brief review of the evaluation and treatment of both febrile and afebrile seizures in those under the age of one year in the emergency department.
Seizures in the First Year of Life Read More »
Before performing your next HEENT procedure in the emergency department, consult this comprehensive description and tutorial that covers a wide range of diagnoses and indications, from mandibular dislocation reduction to nasal septal hematoma drainage. Never call your ENT consult again!
HEENT: Tips for Addressing Your Next Procedure Read More »
Young patient or old…every emergency physician has come across these questions: Should I send a troponin for supraventricular tachycardia, or not? If I do, what does it mean if it comes back elevated? What comes next?
Abdominal compartment syndrome (ACS) has come to the forefront of emergency medicine, critical care, and resuscitation literature. Why does this condition occur, how is it diagnosed, and what can you do if you suspect ACS? This post provides a comprehensive review of ACS.
Abdominal Compartment Syndrome: When Should It Be On Your Differential? Read More »
Learn the complete ED management of acute complications in sickle cell patients
The Sickle Cell Patient – ED Management of Acute Complications Read More »
Please see prior post here: http://www.emdocs.net/reversal-of-anticoagulation/
On October 16, 2015 the FDA granted accelerated approval of idarucizumab (Praxbind), a novel reversal agent of the direct thrombin inhibitor Dabigatran (Pradaxa), for utilization in life-threatening bleeding emergencies.1
Reversal of Anticoagulation in a True Emergency – An Update Read More »
Nearly 65,000 patients visit U.S. emergency departments annually for anticoagulant related hemorrages.1 Despite this staggering amount, the aforementioned figure does not reflect adverse bleeding events associated with Direct Thrombin Inhibitors (DTIs) and Factor Xa Inhibitors.
As EM Docs, it goes without saying that we need to know what to do to address these potentially life-threatening bleeds, so, let’s take a look at the commonly prescribed oral anticoagulants, their mechanisms of action, their pharmacokinetics, and recommendations for their reversal.
Reversal of Anticoagulation in a True Emergency Read More »