FOAMED

In the midst of flu season with patients flooding your ED with similar presentations, what else do you need to consider? This post examines mimics of the flu, with pearls and pitfalls.

What do you do with the head trauma patient who is anticoagulated? Do you discharge the patient, observe and repeat CT, or admit the patient? This post evaluates this question and more.

Pearls and pitfalls in managing the trauma patient and finding occult pathology: a little knowledge goes a long way

The first post in the new EM Primer Series…What are the pearls you need to know for myxedema?

Endophthalmitis is a rare, but clinically significant infection. It is often misdiagnosed due to the multitude of other ocular diseases that share similar presenting symptoms. It results from an infectious or non-infectious inflammatory process of the vitreous and aqueous humors. Missed or late diagnoses can have severe consequences, including permanent vision loss. The natural history of the disease thus necessitates a high degree of clinical suspicion in all patients, especially those at increased risk.

Hemolytic uremic syndrome is a potentially deadly disease, comprised of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and acute kidney injury (AKI). This post evaluates the pathophysiology, evaluation, and management of HUS.

In 2002, a new standard of care was established when the Surviving Sepsis Campaign (SSC) highlighted the importance of recognizing sepsis and initiating treatment early. Once we find that a patient meets Systemic Inflammatory Response Syndrome (SIRS) criteria with a source of infection, rapid and appropriate treatment including resuscitation is a must. Early fluid resuscitation is necessary for septic patients, but there is large variance on the aggressiveness of fluid resuscitation. There is disagreement amongst the experts on the total amount of fluids that should be administered and the end points for resuscitation. We must ask ourselves, at what point does our aggressive resuscitation actually start to harm our patients?

Does your choice of fluids for resuscitation in sepsis matter? Multiple studies have been performed to determine whether septic patients benefit from colloid versus crystalloid IV fluids, and other studies have specifically looked at the different kinds of fluids within those specific groups. Debate now exists as to which fluid will improve patient outcomes.

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