In terms of airway management, cricothyrotomy is one of the most advanced airway procedures an ED physician will perform. It is a last resort procedure when a patient is not able to be ventilated/oxygenated and/or intubated. Typically, this procedure requires the identification of certain landmarks such as the cricothyroid membrane, but what if you can’t identify any landmarks? What do you do? We got Rob Bryant on the show to discuss some aspects of a recent nightmare airway case he had. Read more →
Author Archive for: srrezaie
Many of us have heard the saying that emergency medicine is the best 15 minutes of every other specialty. This, is in part, due to the wide breadth of disease and knowledge one must have to take care of patients. In emergency medicine we typically focus on acute disease specific problems and life sustaining treatments, but as the population gets older we are also having to deal with chronic conditions as well. This was not an area that I was trained in residency, but certainly one that I am seeing more and more often. There was a great review article published in the Journal of Emergency Medicine in January of 2018 titled, Palliative Care Symptom Management in the Emergency Department: The ABC’s of Symptom Management for the Emergency Physician. The lead author of this paper is Mari Siegel, MD, who I had the pleasure of interviewing for this episode.
Background: I received a text message from one of my colleagues inquiring about discharging a patient home with isolated traumatic subarachnoid hemorrhage and to be honest I had heard about this practice, but was not completely aware of the literature around it. Turns out from a PubMed search there was a meta-analysis published just this past year trying to answer this very question. When I was a resident, which is not that long ago, the standard practice was for patients to be assessed by neurosurgery for management which usually involved ICU admission or a trip to the OR with ICU admission. Isolated traumatic subarachnoid hemorrhage (itSAH) is typically defined as the presence of a SAH in the absence of any other traumatic radiographic intracranial pathology. So the question is, is it safe to discharge patients home with itSAH? Read more →
Anyone speaking on the international/national level has run into AV difficulties and there is nothing more stressful than not being prepared to handle it. In this post, what every speaker needs to have when traveling to a conference, we (Salim Rezaie, Natalie May, and Anand Swaminathan) have listed the things we take with us anytime we travel to speak at a conference to ensure our presentation works no matter what connections a venue may have. Read more →
Background: Congestive Heart Failure (CHF) is one of the leading causes of hospitalization among adults over the age of 65 years of age. Despite improvement in outcomes with optimal medical treatment, admission rates still remain high with many patients requiring rehospitalization. The staples of CHF management include ACE inhibitors, ARBs, beta blockers, diuretics, aldosterone antagonists, hydralazine/nitrates, and digoxin. Recently, I have seen an increase of patients with CHF on a new medication called Entresto (Valsartan-Sacubitril or LCZ696) I did not know much about this medication, or the evidence base for it.