Top emDocs Posts of 2019

Authors: Brit Long, MD (@long_brit – EM Attending Physician, San Antonio, TX), Manpreet Singh, MD (@MPrizzleER – Assistant Professor of Emergency Medicine / Department of Emergency Medicine – Harbor-UCLA Medical Center), and Alex Koyfman, MD (@EMHighAK – EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital) 

Thank you to our readers, our amazing contributing authors, and our awesome editorial staff this past year!  You and your amazing support always keep us going and motivate us to continue providing great content for the FOAMed community. 2019 saw the further development of several great emDocs series and the introduction of the new series – Cleavon MD by Cleavon Gilman, OBCast by Ben Shepherd, and Unlocking Common ED Procedures from Anthony DeVivo. Happy Holidays and Happy New Year!

Now, without further ado, here is our list of our top posts from 2019 based on viewership from you the readers:

Push-Dose Vasopressors: An Update for 2019

How should you use push-dose vasopressors in the ED, including epinephrine and phenylephrine? This post from Kayvan Moussavi and Scott Fitter looks at the evidence behind their use and provides key points for patient care. As an added bonus, the post contains cards that can be printed for easy use on shift.

Basilar Skull Fracture: Basics & Beyond

This post from Saran S. Pillai and Sameer Desai is filled with the basics, pearls, and more regarding basilar skull fractures, providing what you need for the diagnosis and management of these injuries.

Hypertensive Emergency: Pearls and Pitfalls for the ED Physician

From Ashley and Brooke Barlow comes key pearls in managing the patient with hypertensive emergency, with discussion of medications and great infographics you can download for your shift.

Normal Lactate, but a Sick Patient… Lactate is Not Everything

Historically we’ve equated lactate with sepsis, but what else can cause an elevated lactate?  When it comes down to it, lactate is only a number. This post from Carolina Camacho-Ruiz and Mark Silverberg investigates the ins and outs of this laboratory marker.

Wounds and Lacerations in the ED: Management Pearls and Pitfalls for Emergency Physicians

Sometimes wounds and lacerations aren’t straightforward. This post from Jenna Bryant and Joby Thoppil brings you pearls and pitfalls for the evaluation and management of wounds and lacerations.

Droperidol Use in the Emergency Department – What’s Old is New Again

Droperidol is back…. but when and how should you use it? David Cisewski, the editor of our Pain Profiles series, provides you with a primer on droperidol in the ED.

Clostridium difficile in the Emergency Department: Evaluation and Management

How can you optimize your evaluation and management of patients with Clostridium difficile colitis? This post from Brandon Carius and Brit Long provides keys in the diagnosis and management of C. difficile.

emDocs Cases: Evidence-Based Recommendations for Rhabdomyolysis

In this edition of emDocs Cases from Brit Long, we look at the evidence concerning rhabdomyolysis. What history/exam findings suggest the condition? Is CK level related to renal injury? What fluid is best? Are sodium bicarbonate and mannitol helpful? What’s the disposition? We look at these and more.

Pediatric Mechanical Ventilation in the Emergency Department: Taking Away the Big Anxiety Over Small Lungs

What do you get when you take a pediatric patient and add mechanical ventilation?  Probably a lot of anxiety… This post from Joe Ravera and Skyler Lentz will help you conquer mechanical ventilation in pediatric patients.

Spiked Helmet Sign: An Electrocardiographic Indication of Impending Doom

Ready for the spiked helmet sign? This post from David Cisewski and Lillian Wong provides you with what you need to know on the ECG.