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 ...
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 ...
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 ...
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 ...
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 – ...
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 ...
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, ...
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 ...
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 ...
Background: In patients with compromised renal function, the use of intravascular iodinated contrast material is generally not given to avoid contrast induced nephropathy (CIN). Currently, there is no treatment for contrast-induced nephropathy, therefore the focus has been on prevention. Guidelines ...
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