Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Lumbar punctures can be a high stress and difficult procedure for many. Dr. Knudsen-Robbins walks us through the optimal setup, performance, and troubleshooting of this procedure, including the ultrasound-assisted LP! Check out this article before your next LP attempt to breeze through this procedure with ease.

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Diagnostics and Therapeutics: Vascular Access in the Emergency Department

Diagnostics and Therapeutics: Vascular Access in the Emergency Department

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. However, in at least 10% of patients, blind insertion of a peripheral IV may be unsuccessful for a variety of reasons. In this post, we will review multiple alternative access options, as well as briefly discuss concerns related to PICC lines.

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Diagnostics: Dysnatremias

Diagnostics: Dysnatremias

Abnormal sodium values are a common finding on basic metabolic testing, however the more deranged the value, the more critical it is to think causation, as interventions to treat the abnormality can become as dangerous as the abnormality itself. Join Dr. Chhabria as she dives into the causations and treatments of dysnatremias

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Therapeutics: Platelet Coagulopathy Fixes with ITP, TTP and DIC

Therapeutics: Platelet Coagulopathy Fixes with ITP, TTP and DIC

Join Dr. Moulds as she dissects the difficult landscape of thrombocytopenia, where cause is king and sometimes the therapy can be more harmful than watchful waiting. Keep this one in your favorites for the next time a critical thombocytopenic patient rolls in…

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Your Migraine Cocktail Didn’t Work? Shake it Up!

Your Migraine Cocktail Didn’t Work? Shake it Up!

You’ve tried prochlorperizine, ketorolac and fluids and are about to triumphantly discharge the patient when they stop you and inform you they’re still in a debilitating pain. What’s your move? Join Dr. Martina Diaz as she reviews second line and alternative therapies in the management of acute headaches.

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Grand Rounds Recap 12.2.20

Grand Rounds Recap 12.2.20

We had a great Grand Rounds with nine lectures!

Dr. Fermann gave us operations updates for the CEC. Dr. Dave Thompson discussed quality improvement, root cause analysis, and the Pareto Principle. Dr. Tillotson walked us through the types of hypertension seen in pregnancy and how to manage these patients. Dr. Walsh found a sandwich in a patient’s airway. Dr. Jarrell discussed the exciting specialty called Social Emergency Medicine. Dr. Koehler showed us how to use a Minnesota tube for massive UGIB. Dr. Milligan discussed complex cardiac devices including IABP, Impella, and LVAD. Dr. Hassani reviewed post partum headaches and evidence on neuroprotective intubation. And lastly, Dr. Gleimer made us exercise our System 1 and System 2 thinking.

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Diagnostics: Flex your D Dimer

Diagnostics: Flex your D Dimer

In times of COVID, a Dimer of 3000 is nothing to look twice about, however there was an earlier (and future) time where the D Dimer is the hallmark of pulmonary embolism risk stratification. Dr. Comiskey breaks how how this once dichotomous tool has recent data to increase its specificity in elderly patients, pregnant patients and those with low pretest risk factors. Take a look, and when this whole pandemic is over your quiver will be fuller of Dimer tips.

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Diagnostics: Brain MRI

Diagnostics: Brain MRI

If you have ever nodded along as someone described an MRI series weighting, you are not alone. As this modality becomes more accessible to the Emergency Physician, it is incumbent on us to familiarize ourselves with the critical aspects and critical diagnoses of MRI and how to speak the language. Dr. Zalesky takes us on a tour of the physics, indications and low-down of MRI from the ED.

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Diagnostics: Musculoskeletal Ultrasound

Diagnostics: Musculoskeletal Ultrasound

Ultrasound continues to push into more and more of the physical exam, and nowhere is that clearer than in the musculoskeletal exam. From diagnosing and prognosticating patellar tendon ruptures and ligamentous injuries to being a procedural adjunct in shoulder dislocation to critical identification of necrotizing fasciitis, it continues to push boundaries. Dr. Broadstock gives us a look at some of the applications you need to make yourself a better practitioner in this week’s Diagnostics of Musculoskeletal US post.

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