"Pleuritic chest pain [...] is not in a validated clinical decision rule despite having a higher OR for PE than hemoptysis and recent immobilization"The PERC rule can be a wonderful thing, but requires judicious use. Jason West, MD reviews the literature, discussing applicability and limitations of ...

"There have been a growing number of cases associated with life-threatening neurotoxic effects and cardiotoxic effects"Cynthia Santos, MD gives a nice overview of the increasingly popular synthetic cannabinoids, including the range of clinical presentations, management, and the bottom line for your practice in the ED.

"Ketamine provides excellent analgesia with no or minimal effects on perception or emotion"We are very excited to bring you a post from Reuben Strayer, MD (@emupdates) on ketamine as an alternative to opiates for pain relief in the ED. The discussion highlights indications for use, dosing recommendations, and how to avoid potentiating the medication's psychiatric effects.

"Targeting light sedation within the first twelve hours of intubation decreases morbidity and mortality"Taking a thoughtful approach toward keeping your intubated patient comfortable is not just the humane thing to do - it can make a big difference in their ultimate outcome. Rachel Shard, MD discus...

"Some have questioned exactly which parts of the bundle are beneficial, which parts are not, and which parts may be causing harm"Steven Whelpley, DO reviews the recent literature on sepsis recognition and treatment in the ED.

"Significant cause of strokes in young/middle aged patients"Olabiyi Akala, MD summarizes the signs, symptoms, and imaging options for making the diagnosis of carotid artery dissection, and discusses current controversies in management.

"Recent studies have suggested that the timing of surgery may be less important for overall outcomes. Rather, outcomes may be more related to the extent of cord compression at presentation"Jennifer Robertson, MD, MSEd brings us an update on cauda equina syndrome, including making the diagnosis, timing of surgery, and medicolegal risks.

Rachel Wightman, MD presents the case of a 33 year-old female with two days of pelvic and rectal pain.