Archive for category: Clinical

Triage ECGs: Reducing Interruptions in a Busy ED

09 Mar
March 9, 2017

Background: Lets face it. All of us have been interrupted by the onslaught of triage ECGs for interpretation.  This constant flow of pink paper with black scribble causes frequent task switching, interrupts train of thought, and ultimately can lead to medical errors, which affects the patients in front of us.  On the other hand, it […]

Pediatric Septic Hip

06 Mar
March 6, 2017

Pediatric Septic Hip Definition: Bacterial infection of the hip joint space and synovial fluid Background: Causes Hematogenous spread in bacteremia Local spread (i.e. from osteomyelitis) Direct inoculation (traumatic or surgical) High-Risk Subgroups Age < 2 years (peak incidence 6 – 24 months) Immunocompromised state (i.e. AIDS, active cancer, etc) Functional asplenia (i.e. sickle cell disease) Complications […]

Effectiveness of Diazepam Adjunct Therapy in Acute Low Back Pain

02 Mar
March 2, 2017

Background: Low back pain is an extremely common presentation to US Emergency Departments (EDs) representing 2.4% or 2.7 million visits annually. The vast majority of presentations are benign in etiology but can be time consuming and frustrating for both patients and physicians. For patients, most will have persistent symptoms a week after presentation and many […]

Fluid Responsiveness and the Six Guiding Principles of Fluid Resuscitation

27 Feb
February 27, 2017

Background: Fluid resuscitation is a crucial aspect of emergency and critical care. Since the advent of the concept of early goal-directed therapy, we have placed a huge emphasis on aggressive fluid resuscitation in patients with severe sepsis and septic shock. From EGDT to PROCESS/ARISE/PROMISE to Surviving Sepsis Guidelines, we have seen a shift in how fluid […]

The Good, The Bad, and The Ugly of Proton Pump Inhibitors in UGIB

23 Feb
February 23, 2017

Upper gastrointestinal bleeding remains a common reason for emergency department visits and is a major cause of morbidity, mortality, and medical care costs. Often when these patients arrive, the classic IV-O2-Monitor is initiated and hemodynamic stability is assessed. One of the next steps often performed includes the initiation of proton pump inhibitors (PPIs). The ultimate question however […]

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