Archive for category: Clinical

Post-Partum Hemorrhage

15 Jan
January 15, 2018

Definition: Blood loss > 500 ml after a delivery (or > 250 ml after an abortion). The management of post-abortion hemorrhage is similar to that of post-partum hemorrhage (PPH). Causes Uterine atony (~ 50% of cases) Retained products of conception (POCs) Cervical lacerations Uterine perforation Uterine Inversion Abnormal placentation (accreta, increta, percreta) Coagulopathy Background: Occurs […]

REBEL Cast Ep 43: Pain Control and Opioid Sparing Options in the ED

08 Jan
January 8, 2018

Background: In the United States we are not only seeing an opioid epidemic but also a shortage of IV opioid agents. For both reasons, it is important to find non-opioid options for common pain complaints seen in the ED.  Changing prescribing practices is difficult but an important step in minimizing opioid usage.  Current research suggests […]

Effect of POCUS in Cardiac Arrest on Compression Pauses

14 Dec
December 14, 2017

Background: The provision of high-quality compressions with minimal interruptions is central to the management of cardiac arrest. Along with defibrillation, high-quality compressions are the only interventions proven to improve patient-oriented outcomes. Recently, point-of-care ultrasound (POCUS) has gained greater use in cardiac arrest care for determination the cause of arrest as well as guiding the resuscitation and […]

Topical TXA in Epistaxis

07 Dec
December 7, 2017

Background: Epistaxis is a common Emergency Department (ED) complaint with over 450,000 visits per year and a lifetime incidence of 60% (Gifford 2008, Pallin 2005). Standard anterior epistaxis treatment consists of holding pressure, use of local vasoconstrictors, topical application of silver nitrate and placement of an anterior nasal pack. ED patients with epistaxis often fail conservative […]

Bacterial Endocarditis

04 Dec
December 4, 2017

Background: Definition Infective Endocarditis (IE) = Inflammation of the endothelium of the heart, heart valves (or both) (Osman 2013) Epidemiology Annual incidence = 5-7 cases per 100,000 (Fraimow 2013) 40,000 to 50,000 new cases in the US per year. Average hospital charges in excess of $120,000 per patient (Bor 2013) Slightly higher male predominance (1.5:1 […]

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