Wednesday Wrap-Up: 4/18/12

Special thanks to the SIM team and all those who participated in our Sim Throwdown/ Rumble/ Battle Royale. Congratulations to Drs. Aherne, Kendall and Grock for winning our first Sim Competition! Take home points from the simulation cases: 1)  When…

Morning Report: 4/17/2012

Dr. Kazzi presents some clinical pearls about preoxygenation for today’s Morning Report (originally presented 4/10/2012):   Preoxygenation   Physiology of Preoxygenation: Preoxygenation extends the duration of safe apnea (defined as the time until a patient reaches a saturation level of 88-90%) Below…

Morning Report: 4/16/2012

Today’s Morning Report is courtesy of Dr. Melendez (presented 4/12/2012). Follow the along and think about how you would handle this scary presentation.   A mother brings her 9 day old infant in because “she has not urinated in the…

EKG 2 answer

Answer and ECG submitted by Dr. Eli Brown.   Thanks Richie/Shin.  Good work in spotting the “widow maker. “ I would like to point out that this patient actually has poor R-wave progression. That, along with the QS complexes (III,…

Morning Report: 4/12/2012

Thanks to Dr. Guy for today’s Morning Report (presented on 4/9/2012)! Central Retinal Artery Occlusion Epidemiology:  55% mortality rate over 9 years 2% bilateral involvement mean age 62   Pathophysiology:  emboli in retinal artery/ branches ophthalmic artery from intraorbital branch…

Morning Report: 4/9/2012

Today’s Morning Report is thanks to Dr. Willis with some clinical pearls about strangulation/hanging injuries:   Strangulation / Hanging injuries   Mortality: Death from injury to spinal cord or brainstem, mechanical constriction of neck structures, bradycardic cardiac arrest (carotid sinus…

Morning Report: 4/5/2012

Thanks to Dr. Brothers for putting together today’s morning report (which was presented on 4/2/2012)! Here’s the case: 35 yo F history gastric bypass surgery 7 years ago presents with severe epigastric pain. Denies N/V/D. Has been constipated for past…

EKG 2

Here’s another EKG to get you guys talking. Thank you Dr. Silverberg and Dr. Brown for the case. 73 chinese female h/o dm, htn and high cholesterol had syncopal episode. Felt heart racing and palpitations prior to passing out at…

EBM: 4/2/2012

Welcome to the first Evidence Based Medicine blog entry, where we discuss the mounds or molehills of data for what we do in the ED. Are we practicing dogma? Or is there some science behind it? For the first topic,…

Wednesday Wrap-up: ICU Conference 3/28/2012

ICU Conference 3/28/12 Follow-Up: Serotonin Syndrome and NMS Pt on “multiple psychiatric medications” presents to the ER “acting strangely”…  after doing a physical exam and excluding other potential causes, your primary differential includes… Serotonin Syndrome Epidemiology: Occurs in 15% of patients…

Morning Report: 3/28/2012

Here are some clinical pearls on cyanide poisonings from yesterday’s morning report by Dr. Audrey Tan: CYANIDE POISONING Sources Ingestion – chemists, photographers, jewelers, lab techs have access to cyanide salts Smoke inhalation – release of cyanide from combustion of…

Morning Report: 3/26/2012

Thank you to Dr. Aherne for this edition of Morning Report, Gamekeeper’s Thumb/Skier’s Thumb   Injury to the Ulnar Collateral Ligament (UCL) of the thumb True gamekeeper’s thumb is a chronic condition, due to repeated valgus force on MCP joint…

Morning Report: 3/23/2012

Thank you to Dr. Backster for today’s Morning Report with some clinical pearls on lightning injuries: . Lighting strikes Neg charged lightning: more common, occurs within the storm Pos charged lightning: stronger, longer exposure, & can occur miles from the…

EKG Blog

Hey guys, Check out this case and let me know what you think. I will post the answer and discussion in 1-2 weeks. 45 year old male with history of abnormal heart beat, htn complaining of difficulty breathing and palpitations.…

Morning Report: 3/21/2012

The Dr. Audrey Tan Advice Column (Actually Morning Report from 3/20/2012) Practical Advice.  Not so sexy but definitely necessary. ABSCESSES To pack or not to pack to prevent recurrent/repeat infection? 7 prior controlled studies suggesting that packing prolongs wound healing…

Morning Report: 3/19/2012

From the case files of Dr. Wendy Lau, Emergency Physician: An 11 year old male with no significant past medical history presents with chest pain x 5 hours.  Patient states the pain started suddenly while running in school.  The pain…