In the evaluation of SAH in the ED, does everyone with a negative head CT require subsequent LP? On 1/29/14!, we’ll review Perry’s study in BMJ on CT performed within 6 hours of headache onset. Practice-changing? Peruse and decide. Enjoy! and please post your thoughts, comments and questions below. http://www.bmj.com.newproxy.downstate.edu/content/343/bmj.d4277?view=long&pmid=21768192 Read more…
The debate on the treatment of circulatory shock is over(-ish?). Ever since the NEJM put out its big RCT on the treatment of all-comer shock[i], we know that norepinephrine is the vasopressor of choice. Septic, cardiogenic….doesn’t matter. Norepinephrine is superior to dopamine. Bummer, right? Choice of vasoactive agent was so Read more…
Thanks to Dr. Shin for a very timely Morning Report! Carbon Monoxide Toxicity Carbon Monoxide: Colorless and odorless and created by incomplete combustion Common sources are automobile exhaust, coal, wood or kerosene stoves Pathophysiology: CO binds reversibly to hemoglobin 230-270x that of oxygen causing functional anemia Half Read more…
Dr. Reisman presents today’s Morning Report! What is the evidence for pre-hospital spinal immobilization of trauma patients? Routine spinal immobilization in trauma patients: What are the advantages and disadvantages? S. Abram, C. Bulstrode The surgeon: journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 1 August Read more…
Here’s a Friday the 13th edition of Morning Report presented by Dr. Waldman! The Case: 42 yo F hx of asthma, heavy smoker p/w 3 days of wheezing and SOB. Pt had been admitted for asthma in the past but never intubated. Albuterol and ipratropium were not helping at Read more…
Thanks to Dr. Lewis for today’s Morning Report! Coumadin-induced Coagulopathy Coumadin Antithrombic effect: blocks activation of vitamin K → interferes with hepatic carboxylation of coagulation factors II, VII, IX and X → impairs the extrinsic and common pathway Prothrombic effect: Blocks activation of protein C and S Circulating Read more…
Welcome to Save of the Month! where each month we recognize a resident who went above and beyond to make a great save in the ED. Nominations are solicited from the faculty each block and we pick one resident for recognition and embarrassment on this blog. This month’s edition goes to . Read more…
Thanks to Dr. Louis for today’s Morning Report! Hypercalcemia Definitions: – The normal reference range of serum calcium levels in adults is 8.7-10.4 mg/dL – Mild hypercalcemia is 10.5 – 11.9 mg/dL – Moderate hypercalcemia is 12.0-13.9 mg/dL – Severe hypercalcemia is > 14.0 mg/dL Epidemiology: -Primary Read more…
Today’s Morning Report is presented by Dr. Freedman! The Case: Left Ventricular Hypertrophy Definition: increased mass of the left ventricle How?: Things that cause increased afterload HTN Aortic Stenosis Coarctation Genetics HCOM Volume Overload? Mitral Regurg Aortic Regurg Why do we care? risk of development of CAD risk Read more…