Take Home Points: Get definitive airway control when necessary Use modality you’re most comfortable with Hard signs – pulsatile bleeding, bruit or thrill, expanding hematoma, airway compromise, massive hemoptysis (think airway injury), hematemesis (think esophageal injury), grossly injured trachea, neurologic ...
Background: Epinephrine (adrenaline) has been used in advanced life support in cardiac arrest since the early 1960s. Despite the routine recommendation for its use, evidence to support administration is less than ideal. Although it is clear from multiple observational studies ...
Background: Working in the emergency department means frequently performing painful procedures on patients, often we turn to procedural sedation to make these procedures more tolerable for patients, families and clinicians alike. Ketamine is often used for this purpose, particularly in pediatrics, ...
Background: Convulsive status epilepticus is the most common pediatric neurological emergency worldwide. Currently, phenytoin (UK & Europe) or fosphenytoin (USA) is the recommended second-line IV anticonvulsant for the treatment of pediatric status epilepticus. Some evidence and providers however suggest that ...
Background: Migraine is a chronic neurologic disease characterized by attacks of throbbing, often unilateral headache that are exacerbated by physical activity and associated with photophobia, phonophobia, nausea, vomiting, and, in many patients, cutaneous allodynia. Migraine is very common, and the burden ...
Normal saline started being used based on work done in the 1830s with cholera. We are still doing the same thing the same way and it’s not until recently we have begun to ask the hard questions about why we ...
Background: Unwarranted use of antibiotics has several deleterious effects which include, antimicrobial resistance, wasted resources, adverse effects, negative affect on the microbiome of patients, and distracts from potentially more effective interventions. There has recently been a huge push for tests such ...
Take Home Points Myxedema coma is severe, decompensated hypothyroidism with a very high mortality. Classic features include: decreased mental status, hypothermia, hypotension, bradycardia, hyponatremia, hypoglycemia, and hypoventilation Work up includes looking for and treating precipitating causes, most commonly infection as ...
Background: Antibiotics are one of the cornerstones of therapy in the treatment of sepsis/septic shock, however according to the Surviving Sepsis Campaign (SSC) guidelines, time to antibiotics is a core measure, though there is weak evidence in support of this. Most ...
Background: The clinical diagnosis of pulmonary embolism (PE) can be challenging given its variable presentation, thus requiring dependence on objective testing. Decision instruments such as PERC and the Wells’ score help stratify patients to low or high probability, enabling focused ...
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