Category: Staten Island Corner

Cracking Skulls

    Scenario: You are evaluating a 58-year-old male with hypertension and cirrhosis who presents with a sharp, right-sided, severe, non-radiating, constant headache that started suddenly two hours ago while he was walking to get something to eat. Shortly after…

Cellulitis – Observe, Admit, or Discharge?

Cellulitis is commonly diagnosed and treated in the Emergency Department, with considerable variation in treatment and disposition patterns. These patients are either: Given a dose of intravenous (IV) antibiotics before discharge home Placed on observation units for IV antibiotics before…

Is BMI-Adjusted BNP a Real Thing?

  Let us set the scene: You have a patient complaining of shortness of breath. The patient gives a poor history, but your spidey sense tells you this is obstructive pulmonary disease vs. new-onset heart failure. His corpulent body habitus…

VBG vs ABG in Hypercarbia

The blood gas analysis offers important data to guide the treatment and prognostication of critically ill patients. Providers are able to quickly assess acid-base status, tissue perfusion, and respiratory mechanics. Traditionally, providers relied on arterial blood gas (ABG) for these…

Refractory Shock

It’s a busy night shift when a nurse alerts you to an elderly patient sent from a nursing home who is hypotensive, tachycardic, tachypneic, febrile, altered, and appears dehydrated.  You assume sepsis, send labs, begin treating empirically with broad spectrum antibiotics, and…