Archive for category: Mythbuster

Urinary Retention: Rapid Drainage or Gradual Drainage to Avoid Complications?

04 Apr
April 4, 2017

Background: The treatment of urinary retention is pretty straightforward; place either a Foley catheter or suprapubic catheter to decompress the bladder.  What is less clear, and more often debated, is if we need to clamp the catheter after 200 – 1000mLs of urine output or just allow complete drainage.  Historic teaching has been to do […]

Mythbuster: Glucose Levels Must be Below a “Safe” Threshold Before Discharge

01 Dec
December 1, 2016

Background: Anyone who works in the Emergency Department has seen patients brought in by EMS or sent from the clinic with a chief complaint of “high blood sugar.”  Now, we are not talking about patients with diabetic ketoacidosis, but just simple hyperglycemia. This is a common complaint with no real consensus on optimal blood glucose […]

Should We Give Fingertip Amputations with Exposed Bone Prophylactic Antibiotics?

14 Dec
December 14, 2015

Background: Fingertip amputations are not an uncommon injury seen in the emergency department. Treatment options range from healing by secondary intention to flap coverage or replantation. Selection of the appropriate treatment modality depends on the nature of the injury, the physical demands of the patient, and the patient’s co-morbidities. Prophylactic antibiotic use in patients with […]

Is Too Much Supplemental O2 Harmful in COPD Exacerbations?

03 Dec
December 3, 2015

Background: It’s common practice to give carefully titrated supplemental oxygen therapy for patients in COPD exacerbation. We give enough O2 to prevent hypoxemia, but not so much that it causes hypoventilation or dangerous hypercarbia. If you’re like me then you’ve probably heard a number of conflicting theories as to WHY overzealous supplemental oxygen leads to […]

More Dogma: Epinephrine in Digital Nerve Blocks

03 Sep
September 3, 2015

You are working as an EM resident and have just evaluated a patient with a right long finger DIP joint dislocation. You perform a digital nerve block with 1% lidocaine with 1:100,000 epinephrine, and go to present to your attending before attempting the reduction. Your attending, on hearing about the epinephrine use goes berserk, and […]

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