Riding the Waves: End-Tidal CO2 Monitoring

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Riding the Waves: End-Tidal CO2 Monitoring

End-Tidal CO2 monitoring has a variety of uses in the Emergency Department.  Whether used diagnostically or for monitoring of a patient’s physiology, clinicians must possess an understanding of the information that you can gather from EtCO2 waveform tracings. Knowing how to interpret the waveforms makes EtCO2 much more than a number, allowing the clinician to gain insight into minute to minute changes in a patients physiological state.

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Foot Injuries in the ED

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Foot Injuries in the ED

As an EM physician, it is important to have an understanding of the spectrum of foot injuries and how these are appropriately evaluated. Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED. This post will cover some of the most common and important injuries, but is not comprehensive. Injuries discussed are shown in Image 1.

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Twisting and Turning - Ankle Injuries in the ED

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Twisting and Turning - Ankle Injuries in the ED

As an EM physician, it is important to have an understanding of the spectrum of ankle injuries and how these are appropriately evaluated. Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED. This post will cover some of the most common and important injuries, but is not comprehensive.

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Fearsome Foliage - An Overview of Toxic Plants

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Fearsome Foliage - An Overview of Toxic Plants

Spring has sprung... and so have many species of toxic plants! Poison centers across the United States receive over 100,000 reports of exposures to toxic plants annually. It is often difficult for Emergency Medicine providers to determine the quantity and time of exposure. Plant identification presents another challenge, and can even require the input of a botanist. Now that is an interesting consult! Thankfully, some of the more common and/or dangerous plant poisonings have been well-categorized, and are summarized in this post.

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Caustic Skin Injuries

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Caustic Skin Injuries

Chemical burns are also an evolving pathology, with thousands of new chemicals added to the market each year (4). Since 2000, both assault and warfare with chemical weapons have increased, although these pathologies vary based on practice location (1). For instance, chemical burns can comprise up to 14% of burns in the developing world, compared to 3% in the US and Europe (2, 5). It is therefore important to understand your local chemical burn patterns, in much the same way providers learn local patterns of antibiotic resistance.

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Packers, Stuffers, and Pushers

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Packers, Stuffers, and Pushers

Body packers, stuffers, and pushers may present to the emergency department (ED) for evaluation of symptoms or for medical clearance before prosecution. It is important for the ED physician to have a keen framework for diagnosing, evaluating, and treating these patients.

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Do You Hear What I Hear: Tinnitus and Auditory Disturbances

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Do You Hear What I Hear: Tinnitus and Auditory Disturbances

The majority of cases of hearing loss and tinnitus are not immediately dangerous and may be safely deferred to the outpatient setting. There are, however, several etiologies of such complaints that are dangerous and require prompt evaluation in the emergency department. The approach to hearing loss and/or tinnitus in the emergency department must focus on identifying characteristics that may clue the examiner in on a potentially harmful etiology.

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Lymphedema and Its Mimics

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Lymphedema and Its Mimics

Lymphedema is a progressive pathologic condition of the lymphatic system where interstitial accumulation of protein-rich fluid leads to subsequent inflammation, adipose tissue hypertrophy, and fibrosis [1]. The direct effect of this development and its long-term complications can lead to disfigurement, decreased mobility, and significant morbidity. While the management of lymphedema typically requires long-term therapeutic interventions outside of the role of the Emergency Department, a thorough understanding of this condition and its mimics will help Emergency Physicians appropriately evaluate and manage the broad presentation of “swelling”.

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