Archive

Author: Rob Bryant

Abscess Management: The Reformation of an Antibiotic Nihilist

Abscess management has evolved somewhat in the 14 years since my residency graduation. The point at which antibiotics are likely to be more helpful than harmful is not always easy to assess, and evidence based expert opinion has flip flopped …

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Infectious Disease

Peri-Intubation Anaphylaxis

Background: Peri-operative anaphylaxis is an unexpected complication of intubation. The major life threat in anaphylaxis is typically loss of airway, however profound hypotension and circulatory collapse are still possible life threats even in the setting of a protected airway. Peri-operative anaphylaxis is …

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Post Intubation Hypotension: The AH SHITE mnemonic

You have just secured the endotracheal tube following an uneventful intubation of a moderately ill  patient in your emergency department. They had a normal pre-intubation blood pressure.  As you are calling the admit in to the ICU the patient’s nurse tells you …

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Resuscitation

Altitude Adjusted PERC Oxygen Saturation

The PERC rule has been a welcome addition to the emergency department evaluation of patients with chest pain or dyspnea suspected of pulmonary embolism. This has allowed a reduction in D-dimer testing in low risk patients. The traditional saturation cut-off of …

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Thoracic and Respiratory

How to Call a Consult

When on shift in the ED we spend more time with a phone in our hand than a laryngoscope. Despite this, we spend a lot more time finessing our laryngoscopy skills than the way we call our consults. Calling an efficient …

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