After managing the ABC’s for a STEMI patient, you find out the cath lab is being used and cards cannot take the patient yet. You go back to reassess and the monitor shows a wide complex tachycardia at a rate of 110! It looks on the monitor like you have Read more…
ECG STEMI Basics Please describe: 1. What and where the pathology is 2. Where you would see reciprocal changes 3. Which artery is blocked, and 4. What other ECG’s are indicated. By Dr. Brenda Oiyemhonlan, Dr. Andrew Grock, and Dr. Sally Bogoch References: Gorgels, A., Engelen, Read more…
CC: A 60 yo Abe Simpson (father of homer) with a past medical history of htn and anxiety presents to your ED for severe epigastric abdominal pain… HPI: While straining during a bowel movement earlier, the patient suddenly vomited – large volume, non-bloody, nonbilious. After vomiting, he had Read more…
Samwise Gamgee presents to your Emergency Department after an ankle injury. He was in the Mines of Moria when a flock of bats flew all around him and he fell, twisting his ankle. He doesn’t think he got any bites or scratches from the bates. He is ottowa ankle negative Read more…
TPA for MI when PCI is not available – recommended so thoroughly it’s in textbooks. TPA for clotted AV fistulas – surgeons do it. TPA in stroke…not going anywhere near it. TPA for PE…Interested? After a lit search [1] done under the tutelage of Dr. Shahriar Zehtabchi, here’s Read more…
On February 11th, we will be presenting a thorough analysis of the following New England Journal of Medicine paper: Ultrasonography versus Computed Tomography for Suspected Nephrolithiasis by R. Smith-Bindman, et al. Click here for the article Possible questions to comment on and/or ponder: 1. Does this paper change my Read more…
By Dr. Michelle DiMare Welcome back and Happy New Year! While the gallbladder itself and the majority of its pathology are usually considered easily identifiable on basic bedside ultrasound, finding the common bile duct often earns top honors as our nemesis. We must be careful to not Read more…
Case Recap: Old lady with hypotension, tachycardia and JVD… I think we all agree that this person is sick. Prior to pondering the wide differential do the Basics: 2 Large Bore IVs, O2 NC vs NRB, Monitor, assess airway My Top Three Differential Diagnoses 1. Cardiac Tamponade 2. Read more…
Jonny Utah () presents to your ED clutching his knee, grimacing, and firing his weapon unnecessarily into the ceiling. After he puts his weapon down, you assess the leg. He has a deformity to the knee, cannot bear weight, and is NV intact at the foot. Read more…
One of the golden girls (don’t worry, not Blanche) presents to your ER after a near syncopal episode. She reports generalized weakness, but denies all other complaints. VS (scary): HR 136, RR 25, BP 70/30. The pulse ox won’t pick up. She has clear lungs, normal heart sounds, Read more…