practice updates

Suprapubic catheters are a more invasive type of catheter that have specific indications. Patients typically have these long-term and may present to the emergency department with complications related to their catheters. This is a brief overview of some complications of suprapubic catheters and how to manage them.

Sepsis is a condition emergency providers manage daily and has the potential for high morbidity and mortality. Sepsis management requires rapid diagnosis, early administration of intravenous (IV) fluids with broad-spectrum antimicrobials, and source control. But what is the role for steroids in sepsis? What are the potential benefits and risks? This post will explore the evidence surrounding corticosteroids in sepsis management to help shed some light on this controversial topic.

It’s a busy shift. Today no one seems to have a chief complaint.
Someone sends a troponin on a child. Good, bad, or ugly, how are you going to interpret the result?
And while we’re at it – what labs do I need to be careful with in children – sometimes the normal ranges of common labs can have our heads spinning!
Read on for bread-and-butter pediatric blood work and further, to answer the question – what’s up with troponin, lactate, d-dimer, and BNP in kids?

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.

Motorcycle accidents can be deadly. Riders are at high risk of injury due to the dangers of riding a motorcycle, which are vastly different from other vehicles. This post is full of pearls and pitfalls on motorcycle crashes and how to care for these patients.

The purpose of this article is to present a discussion on Lyme using a case based format. The goal is to expand the reader’s differential to include Lyme disease in a multitude of cases, provide tips/tricks for diagnosis and treatment, discuss the role of prophylaxis, and address Chronic Lyme Disease.

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.

Chest pain accounts for approximately 8-10 million healthcare visits in the U.S. per year and can be associated with a variety of benign to life-threatening diseases. Acute coronary syndrome is one of the major considerations in the ED. Approximately 20% of lawsuits are due to misdiagnosis and mismanagement of ACS and a large percentage of patients are admitted due to this risk. However, few admitted patients go on to be diagnosed with ACS. Although commonly used to help risk stratify patients in the ED, there is no evidence that stress testing decreases risk of future cardiac events. This post will examine chest pain risk stratification in the ED and the utility of stress testing.

Organ transplantation is common and challenging in the emergency department. Transplant patients are at risk for a wide variety of complications, especially in the period immediately after surgery. This post will review complications specific to transplanted kidneys, livers and hearts.

Emergency departments cater to patients from all walks of life, some living under better circumstances than others. For those patients enduring difficulties outside the ED that are often unseen, here is a primer to raise that awareness and also encourage strategies to better care for these patients.