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All Categories
  • All Categories
  • Abdominal and Gastrointestinal
  • Allergy and Immunology
  • Cardiovascular
  • Dermatology
  • EMS and Disaster
  • Endocrine, Metabolic, Fluid, and Electrolytes
  • Environmental
  • Ethical and Legal
  • Head, Eye, Ear, Nose, and Throat
  • Hematology and Oncology
  • Human Behavior
  • Infectious Disease
  • Neurology
  • Obstetrics and Gynecology
  • Orthopedics
  • Pediatrics
  • Procedures and Skills
  • Psychiatry/Behavioral Health
  • Renal and Genitourinary
  • Resuscitation
  • Team Performance
  • Thoracic and Respiratory
  • Toxicology
  • Trauma

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

Episode 36 – Resuscitate Before You Endoscopate?

Background: Upper gastrointestinal hemorrhage (UGIH) is a commonly seen complaint in the ED.  Currently, endoscopy is the standard therapy shown to not only help with diagnosis, but also risk stratify patients and potentially offer effective hemostatic treatment of acute nonvariceal ...

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Abdominal and GastrointestinalResuscitation

Are we Missing Acute MIs with Clinical Risk Scores?

Background: In 2011, we saw 7 million patients in the emergency department (ED) complaining of chest pain. Most of these patients did NOT have an acute coronary syndrome (ACS) or an acute myocardial infarction (AMI). Missing an AMI is one of ...

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Cardiovascular

Low-Dose Ketamine for Acute Pain in the ED: IV Push vs Short Infusion?

Background: Ketamine’s role in the ED has expanded in recent years.  The clinical reasons for this make it easy to understand why, and include analgesia, amnesia, and anesthesia. Amazingly, ketamine does not only reduce acute pain, but it also decreases ...

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Procedures and Skills

The Marik Protocol: Have We Found a “Cure” for Severe Sepsis and Septic Shock?

Background: The overall mortality in sepsis has decreased quite a bit in the last decade or so, however for a subset of patients, like those with Septic Shock, the mortality still remains high (as high as 50%).  There have been ...

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Infectious Disease

Is the Future of Non-Invasive Hemodynamic Monitoring Here and Ready for Primetime?

Background: Many physicians struggle with monitoring accurate continuous blood pressures, cardiac output, and response to fluids in patient resuscitation. Also, due to the invasive nature of most methods presently available (i.e. arterial lines, etc) few patients get this monitoring. Ultrasound ...

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Resuscitation

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

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 – ...

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Renal and Genitourinary

Episode 35 – Non Operative Treatment of Appendicitis (NOTA)

Background: Historically the treatment of uncomplicated appendicitis has been appendectomy. The first appendectomy performed dates back to 1735 done by Claudius Amyand. Appendectomy has been the standard treatment for acute appendicitis every since Charles McBurney described it in 1889. However, studies have shown ...

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Infectious Disease

Diabetic Gastroparesis Needs HUGS

Background: Anyone practicing in emergency medicine has taken care of a patient with diabetic gastroparesis.  Although, it is not a sexy topic to discuss, nor a disease process associated with significant mortality, it is associated with decreased quality of life, ...

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Endocrine, Metabolic, Fluid, and Electrolytes

Is Fever the New Hotness in Sepsis?

Background: With the introduction of sepsis 3.0, came the quick sepsis related organ failure assessment (qSOFA) score. The purpose of this score is supposed to be a bedside tool to help predict which patients are at the greatest risk of ...

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Infectious Disease
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