Persistent or intractable hiccups can be both a diagnostic and therapeutic conundrum for the emergency physician. Dr. Charlie Reed takes us through the pathophysiology, evaluation and treatment of this condition, and reveals the dangers that can be harbored by this common symptom.
Read MorePneumomediastinum is defined as the infiltration of air into the mediastinum and its structures. This disease process can be benign, but also requires careful evaluation and management, and in severe cases may require surgical intervention. This post helps the emergency physician learn to both identify and treat this rare but important clinical entity.
Read MoreVenous thromboembolisms (VTE) are difficult enough to diagnose and treat in the standard patient. However, this becomes even more of a challenge in the pregnant patient. In this post, we will discuss in depth the work up of VTE in the pregnant patient, which often requires slightly different risk stratification tools. We will also discuss various treatment options for VTE in pregnancy and the post partum period.
Read MoreBlood transfusion is a typical activity in Emergency Medicine and while consent to the side effects are fortunately uncommon, they are a core skillset so join Dr. Sprys-Tellner in learning the numbers and reactions that define the category.
Read MoreWeakness is a common, though sometimes vague, presenting symptom in the ED. Neuromuscular (NM) weakness can have various causes, ranging from common and relatively easy to diagnose conditions (such as strokes and trauma) to less common and more difficult to diagnose ones (such as vascular pathologies, infections, autoimmune diseases, and neoplasms). This post focuses on how to localize weakness to differentiate types of NM weakness and presents classic cases of diffuse weakness caused by three diseases.
Read MoreWhile not a daily occurrence in the ED, bullous skin diseases (bullous pemphigoid, pemphigous vulgaris, SJS, SSSS) are critical diagnosis for the Emergency Physician to identify and initiate treatment. Join Dr. Rehfeldt as she parses through them.
Read MoreNot every bradycardic patient needs a transvenous pacer… but some do! Join Dr. Sookdeo as she parses through when and how to transcutaneously and transvenously pace your bradycardic patients.
Read MoreDr. Boyer walks us through nuances and management of the highly morbid condition of severe hypothermia.
Read MoreIn this post we examine one of the etiologies behind a frequent ER chief complaint (shortness of breath). Specifically, we take a look at pleural effusions and how to manage them in the emergency department with thoracentesis procedure.
Read MoreIn this post we examine one of the etiologies behind a frequent ER chief complaint (abdominal pain). Specifically, we take a look at abdominal pain and distention due to ascites, and how to manage ascites in the emergency department with paracentesis procedure.
Read MoreA hernia is described as, “the abnormal protrusion of abdominal contents through a defect involving the normal confines of the abdominal compartments” (9). It often involves a portion of the intestine protruding through a weak point of the abdominal wall. The location and size of the hernia often determines the symptoms and complications that a patient will present with.
There are several risk factors that make developing a hernia more likely. Older patients and those who have had prior abdominal surgery may have weaker abdominal muscles or connective tissue which would make it easier for a hernia to develop. In addition, if there is increased abdominal pressure, such as patients with obesity, or those who participate frequently in weightlifting, this is another factor that may put someone at a higher risk of developing a hernia. Finally, those with poor wound healing, such as people who smoke often or patients with diabetes, may be at risk for incisional hernias. (6)
Read MoreSuccessful airway management is one of the cornerstones of every emergency medicine physician’s toolkit, and tracheostomies can often fall under that category of “difficult” or “scary”. In this post, we aim to familiarize learners with the anatomy of the trach airway and basics of trach tubes as well as teach management and troubleshooting of various complications of tracheostomies.
Read MoreWhen does a blood pressure cuff fall short? Dr. Snyder walks us through the use of invasive blood pressure monitoring and arterial waveform interpretation.
Read MoreLumbar 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.
Read MoreEstablishing 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.
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.
