Brief presentations of current topics in Emergency Medicine based upon our senior resident morning reports
Today’s Morning Report is presented by Dr. Adal! Organophosphate and Carbamate Poisoning Epidemiology: 200K fatalities worldwide every year DDx: Cholinesterase inhibitors, Cholinomimetics, Nicotine alkaloids Kinetics: Absorption via ingestion, inhalation or topical contact. Minutes to hours depending on lipophilicity, metabolism and toxicity of compound Pathophysiology: Inhibition Read more…
Thanks to Dr. Rolston-Cregler for today’s Morning Report! Ethylene Glycol Toxicity The Basics Toxic Alcohol with the chemical structure C2H6O2 Main ingredient in antifreeze Sweet taste often attracts children and animals Clinical Presentation Altered mental status Dyspnea may be a manifestation of underlying metabolic acidosis Laboratory Read more…
Dr. Waldman presents today’s Morning Report! AMMONIA TOXICITY Where can we find ammonia: glass cleaners, toilet bowel cleaners, metal polishes, floor strippers, wax removers, smelling salts, some refrigerants, explosives, pharmaceuticals, pesticides, textiles, leather, flame-retardants, plastics, pulp and paper, rubber, petroleum products, and cyanide INHALATION INJURY: Most common Read more…
Here’s Dr. LoCascio with today’s Morning Report! Landmark Guided Wrist Blocks Ultrasound guided blocks are great but we can’t forget how to do it based on landmarks. Median Block Locate the space between flexor palmaris logus and flexor carpi radialis. Insert the needle in this space between the Read more…
Thanks to Dr. Muhlfelder for today’s Morning Report! Inhalant Injuries Initial Mgmt: ABCs, IV, oxygen supplementation, monitor Exam: bronchospasm, airway edema, nares +/- thermal injury initial eval of airway is not good predictor of progressing edema/compromise, progresses over 24-72 hours bronchopulmonary injury + cutaneous burns >30%BSA increases Read more…
Today’s Morning Report is presented by Dr. Corburn! Following blunt facial trauma, a 35 year old patient is noted to have marked proptosis, restricted ocular movement, and decreased visual acuity of the left eye. What is the recommended temporizing maneuver? Anterior chamber paracentesis Carbon inhalation Globe massage Lateral canthotomy Read more…
Thanks to Dr. Gomes for another Morning Report! Beta-blocker Toxicity Receptors Beta 1- primarily in heart muscle. Activation –> increases HR, contractility and AV conduction. Decreased AV node refractoriness. Beta 2- primarily in bronchial and peripheral vascular smooth muscle. Activation –> vasodilation and bronchodilation Beta 3- primarily in Read more…
Dr. Gomes presents today’s Morning Report! PROCEDURAL SEDATION Definition: -technique of administering a sedative or dissociative agent along with analgesia to induce a state that allows patient to tolerate unpleasant procedures while maintaining adequate spontaneous cardiorespiratory function Complications: -oversedation, respiratory depression/arrest, hypoxia, hypotension, prolonged awakening, agitation, nausea/vomiting, Read more…
Supraclavicular CVC Placement First described in 1965 as an alternative method for obtaining central venous access At the insertion site the subclavian vein is closer to the skin than using the infraclavicular subclavian vein approach Insertion sites of the needle include One centimeter lateral to the lateral border of the Read more…
Today’s Morning Report is presented by Dr. Bart! Valproic Acid Background -Used for seizure disorders, BPD, migraine prophylaxis. -Peak concentrations at 6 hours except for enteric coated capsules. -Complications: -COMMON: Sedation, ataxia, weight gain, nausea, tremor, or hair loss -SEVERE: Hepatotoxicity, thrombocytopenia, aplastic anemia, pancreatitis, hyperammonemia (>80 ug/dL or Read more…