What is it good for? Something? Maybe? Remember in medical school when the right answer to everything was cytokines. The mythical inflammatory response; all those interleukins, TNFs, and all other forms of molecular magic that drive our response to infection. The so-called “pyrogens,” or molecular agents causing fever, are Read more…
ED Critical Care Conference: Sept 2013 The Curious Case of AMS with an (initially) Normal CT Head presented by Dr. Andy Grock Case: 24 yo M, no pmhx presents AMS s/p assault. MRI shows Diffuse Axonal Injury. TBI Discussion Severity by GCS Mild >13 Moderate >9 and <12 Severe <8 Read more…
It’s a busy shift in good old A pod. A nurse comes up to you with a bag of blood tubes for a vomiting patient and asks if you want to shotgun labs and give some anti-emetics. You happily oblige, ordering a liter of normal saline, Zofran, and some labs. Read more…
Thanks for all the responses! Here is short version of the answer for those of you with ADD. Keep on reading for the details! Our patient had sick sinus syndrome with a sinus bradycardia on top of her malfunctioning pacemaker. She was admitted to medicine for CHF exacerbation. The inpatient team Read more…
EM-Critical Care Conference: August 2013 PULMONARY EMBOLISM Summary by Dr. Eugene Kang Diagnosis and EKG: -Most common EKG finding: non-specific ST-T changes (at least for our boards) -Other findings: sinus tachycardia, complete or incomplete RBBB, RAD, right atrial enlargement, dominant R in V1, atrial tachyarrhythmias -Some likelihood ratios (see Read more…
So for this post… we’re going to combine some EKG action with some good ole’ CXR reading… Since we’re not just doing Rhythm Nation or X-ray Vision… we’re going to call it Rhythm Vision! Here’s the case: Your patient is little old granny, an 85 year old woman with a Read more…
This was an elderly woman who fell. This is a very difficult case and even with the 12 other views that were offered it was difficult to tell which way the fracture was displaced. This was read by radiology as “Transverse fractures of the left distal radius, ulna and ulnar Read more…
Please describe this fracture below, who ever describes this fracture most accurately will win the amazon gift certificate.
We like to think we’re always practicing evidence-based medicine. So we inform our consultants about likelihood ratios and ask how can they be “so sure.” We try to be very aware of the sensitivities and specificities of the tests we use so that their results can be qualified. But sometimes, Read more…
So in this week’s ICU conference EMS calls in for a notification that there is a 55 yo woman comes in who has a HR of 173, BP 140/91, RR 22, PO2 99% T of 100.1 with multiple AICD discharges. It was a great case with a great EKG. After Read more…