The Pediatric Airway: Pearls and Pitfalls
A great review of managing the pediatric airway with tips on initial assessment, physiology, and equipment.
The Pediatric Airway: Pearls and Pitfalls Read More »
In the Literature
Concussion in Sports: Sideline and Emergency Department Evaluation and Management
A review of concussion in sports: diagnosis, management, imaging indications, and disposition.
Concussion in Sports: Sideline and Emergency Department Evaluation and Management Read More »
Endovascular Stroke Therapy: Is This the New Standard?
Every few years, we come to a crossroads that makes us reexamine our current clinical practice and consider a better intervention. For the past twenty years, patients presenting with acute ischemic stroke have had essentially one option for therapy: intravenous thrombolytics. Since the NINDS-2 trial in 1995 [1], tPA has erupted onto the scene of stroke management and has become the gold standard despite ongoing questions behind the true efficacy of tPA.
Endovascular Stroke Therapy: Is This the New Standard? Read More »
High Altitude Pulmonary Edema: Diagnosis, Management, and Preventive Strategies
The patient with shortness of breath and cough at altitude: How can EM physicians optimize care and outcomes?
High Altitude Pulmonary Edema: Diagnosis, Management, and Preventive Strategies Read More »
Oral contrast for CT abdominal imaging
Is the use of oral contrast for abdominal CT still necessary?
Oral contrast for CT abdominal imaging Read More »
Antediluvian Methods? An Evidence-Based Approach to Wound Irrigation
Updates in wound care: Normal saline or tap water? What pressure do you need to use? What volume is needed? Should you irrigate clean wounds?
Antediluvian Methods? An Evidence-Based Approach to Wound Irrigation Read More »
Medical Expulsion Therapy with Tamsulosin in Ureteral Colic
Is Tamsulosin actually useful for renal stone expulsion? Anand Swaminathan does a deep dive evaluation of the literature. You don’t want to miss this!
Medical Expulsion Therapy with Tamsulosin in Ureteral Colic Read More »
Management of the Trauma Patient’s Airway – Pearls and Pitfalls
Airway management is one of the most challenging and critical skills that the emergency medicine physician must master. This is particularly true in the setting of the trauma patient, where the ABCs of trauma evaluation begin with establishing the patency of the airway and ensuring adequate oxygenation and ventilation before moving through the remainder of the trauma algorithm. It is well known that delays in adequate airway management are one of the most common causes of preventable death in both the prehospital and emergency department setting.
Management of the Trauma Patient’s Airway – Pearls and Pitfalls Read More »
Outpatient Treatment of Pulmonary Embolism
A 64 year-old woman with past medical history of diabetes mellitus type 2 that is well-controlled on insulin, hypertension, and asthma presents with 1 week of shortness of breath and cough productive of blood-tinged sputum. The shortness of breath became suddenly worse about an hour ago as she was walking into your emergency department for evaluation and at that time she had symptoms of pre-syncope. She is denying chest pain, palpitations, diaphoresis, nausea, recent travel, or surgery. The patient takes both a beta-blocker and a calcium channel blocker to control her hypertension. She took all of her medications this morning prior to presentation. The patient has no personal history of cancer and there is no significant family history. She denies the use of tobacco, alcohol, or any other drugs.
Outpatient Treatment of Pulmonary Embolism Read More »
Ketamine and Rocuronium: The New Etomidate and Succinylcholine?
Rapid Sequence Intubation (RSI) is one of the most critically important skills for an Emergency Medicine physician to be able to perform quickly and accurately. All airway management in the emergency department is performed on the unstable patient, often with unknown co-morbidities and a full stomach. In recent years, standard medication choices for induction were etomidate and succinylcholine. While other medications were proposed and tried, several were avoided for hypothetical side effects that have not borne out in recent research. Arguably, the modern combination of ketamine and rocuronium has less significant complications, and provides a superior alternative to etomidate and succinylcholine.
Ketamine and Rocuronium: The New Etomidate and Succinylcholine? Read More »