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.
Read MoreNausea and vomiting, one of the most common complaints in the pregnancy patient, is a common plight of Emergency Physicians. With a barrage of social media and publication bias, we often need rock solid evidence to make anti-emetic decisions that just doesn’t exist. Join Dr. Josh Ferreri as he summarizes the latest data on conquering the queasy.
Read MoreIf you are reading this, you are in one of two places right now.
You may be sitting comfortably, expanding your knowledge, curious about the latest data for anaphylaxis treatment, and preparing for the next time you may see a patient with anaphylaxis. This resource is for you.
Alternatively, you are actively treating and managing a patient with anaphylaxis, looking for an evidence-based guide to support your clinical decisions in this moment. This resource is also for you.
Read MoreOpioid withdrawal is a common presenting complaint in the emergency department. As opioid use disorder prevalence continues to increase, opioid withdrawal will continue to increase as well. Join Dr. Stark to review the mechanism and treatment options for Opioid Withdrawal Syndrome!
Read MoreRemember as a kid when you would come downstairs only to find your parent devouring your hard-earned Halloween candy? Consider it a favor. Though delicious, those globs of sticky sugar are a common culprit of toothaches for kids & adults alike, as well as headaches for emergency room providers. Whether in the emergency department itself, or while being cornered by a neighbor as you head out your front door, we are commonly confronted by someone holding the side of their face in agony, slowly mumbling ‘can you help me doc?’, as they wince in pain in between each word. Though our medical curriculum may not have prepared us for these moments, medicine is all about lifelong learning, so it is up to us to fill the knowledge gaps about those 32 pearly whites that are often the cause of much trouble.
Read MoreTreating pain in pregnancy can be… well… a pain. With limited non-teratogenic options in the prepartum patient, Dr. Finney takes a dive into the evidence behind what you can use the next time you have a gravid patient who needs your help.
Read MorePericarditis is inflammation of the pericardial sac. Classically, pericarditis presents with sharp and pleuritic chest pain which is relieved by sitting up and forward. Pericarditis has multiple etiologies, but is most commonly idiopathic, assumed to be viral, in developed countries (1). Treatment of pericarditis should be targeted to the underlying etiology if possible (1). For presumed viral, idiopathic causes, most patients are treated with non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine (1).
Read MoreHow do you treat acute low back pain that comes into the ED. Do you have a ‘cocktail’? Do you have any injections / stretching that you recommend? Is there data behind any of that?? Join Dr. Gillespie on an evidence-based look at the therapeutics of low back pain in the ED.
Read MoreAngioedema is like urticaria in that both are transient swelling of well-demarcated areas. However, angioedema involves swelling of deeper tissues, producing nonpitting edema of the dermis and subcutaneous layers. It is most often seen in the eyelids and lips, and sometimes in the mouth and throat. While it is not pruritic it may be painful. In the US, angioedema accounts for approximately 100,000 ER visits annually (1). Across the world, 35% of prescriptions written for hypertension are for ACE-inhibitors (>40 million people). With a reported incidence of angioedema in 0.1–0.7% of those patients on ACEI, there are approximately 40,000 cases of ACEI-associated angioedema worldwide annually (2).
Read MoreElevated intraocular pressure (IOP) is a common finding among eye complaints in the ED. Dr. Melanie Yates reviews what we can do in the emergent setting to reduce the IOP with topical and systemic medications and potentially save vision.
Read MoreThe urine drug screen (UDS) is a relatively inexpensive and quick test to obtain in the emergency department, but how useful is it?. You may be tempted to order it for a patient who comes in altered or intoxicated. Before ordering, it is important to understand how the UDS works and its limitations.
Read MoreOcular Ultrasound is an increasing presence in the portfolio of specific tests within the Emergency Physicians’s toolbox of early recognition of pathology. Dr. Logan Ramsey takes a dives into the indications and evidence of ocular ultrasound
Read MoreAppendicitis is the most common surgical emergency that emergency physicians encounter each year. The prevalence of appendicitis in the US is estimated at 7%, with an incidence of 9.38 per 10,000 people annually [1,2]. Appendicitis shares many signs, symptoms, and laboratory features with other acute medical and surgical conditions, including diverticulitis, nephrolithiasis, and ovarian pathologies like tubo-ovarian abscess and ovarian torsion. Diagnostic tools such as the Alvarado score are designed to help emergency clinicians sharpen their diagnostic acumen by stratifying the likelihood of appendicitis based on scoring systems
Read MoreIn 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.
Read MoreAccording to the American Thoracic Society (ATS) in 2018, 1 million patients required hospitalization for pneumonia and there were 50,000 associated deaths. Pneumonia was the leading cause of sepsis and septic shock and not surprisingly therefore qualified in the top 10 most expensive inpatient hospitalizations.(1) Given these findings, some have sought opportunity to develop mechanisms to assess and safely triage pneumonia patients to either inpatient or outpatient treatment strategies based upon pneumonia severity scores. In October 2019, the Infectious Diseases Society of America (IDSA) in conjunction with the ATS published recommendations for the assessment, treatment and disposition of immunocompetent adult patients with community acquired pneumonia which included several clinical decision rules also known as pneumonia severity scores.(2) The recommended decision rules and several associated, emerging tools are reviewed here.
Read MoreSRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
