Patients with corneal abrasions typically come to the emergency department for eye pain. Most physicians treat these with topical antibiotics, oral analgesia, and for those who are lucky enough 48 – 72 hour follow up with ophthalmology. Oral analgesia does a poor job of controlling these patients pain. Tetracaine is an esterase type anesthetic with a onset of action of 10 – 20 seconds and a duration of action of 10 – 15 minutes. Use of topical anesthetics are very effective at reducing pain, but there use is discouraged secondary to poor wound healing of the corneal epithelium. So what is the evidence for topical anesthetic use on corneal abrasions? Read more →
Tag Archive for: Mythbuster
Computed Tomography (CT) scan using radiocontrast is one of the most common imaging modalities used in emergency departments today. Several studies and my own anecdotal experiences indicate that both physicians and patients believe that iodine allergies are linked to seafood allergies and that both are related to a disproportionate increased risk of “allergic” reactions to radiocontrast agents. To add further insult to injury, some hospitals have premedication protocols with steroids and antihistamines requiring up to 12 hours before CT scans with intravenous contrast can be performed. So what is the relationship of radiocontrast, iodine, and seafood allergies? Read more →
- Carotid pulse only = SBP 60 – 70 mmHg
- Carotid & Femoral pulse only = SBP 70 – 80 mmHg
- Radial pulse present = SBP >80 mmHg
Nasogastric lavage (NGL) seems to be a logical procedure in the evaluation of patients with suspected upper GI bleeding, but does the evidence support the logic? Most studies state that endoscopy should occur within 24 hours of presentation, but the optimal timing within the first 24 hours is unclear. Rebleeding is the greatest predictor of mortality, and these patients benefit from aggressive, early endoscopic hemostatic therapy and/or surgery. So what are the arguments for and against NGL?