An overview of Huang, DT et al. (2018). Procalcitonin-Guided Use of Antibiotics for Lower Respiratory Tract Infection. N Engl J Med, 379(3), pp.236-249 https://www.ncbi.nlm.nih.gov/pubmed/29781385 Background: Procalcitonin is an acute phase reactant used to differentiate bacterial from viral infections. Previous Read more…
It’s Friday night in Central Brooklyn, and it’s your 6th night shift in a row. It’s surprisingly quiet in the critical care/resuscitation unit, and that notification phone still hasn’t rung. Just when you sit down, corner deli coffee in hand, trying to figure out if it’s actually Friday or Saturday, Read more…
During a slow morning in the pediatric emergency department last week, I decided to pass the time scrolling through puppy pictures on behalf of National Puppy Day. By page 98,3457 of a Google image search for “puppies,” I imagine a dog barking on the other side of the ED. I Read more…
It is 4 AM in the morning and a 50 year-old male is next to be seen in the emergency department. You think to yourself, what can possibly compel this patient to leave the warm comforts of his bed to come to the ED in the dead of night? Chest pain? Belly pain and vomiting? Either way, you have your treatment algorithm ready in your head until he throws you a curveball. “Hey doc, I got these hiccups I just cannot get rid of…”
You’re sitting in the critical area when EMS bursts through the trauma bay doors with a 34 year-old male with PMH of asthma in respiratory distress. EMS alerts you that they’ve placed a line, started 1g of magnesium sulfate, given 10 mg of dexamethasone, and the patient is on his Read more…
Last month we discussed the use of needle aspiration as an alternative to placing a traditional large-bore chest tube in patients with spontaneous pneumothoraces. One of the selling points of using these less invasive methods is that they decrease the amount of time these patients spend in the hospital. In fact, Read more…
A young, tall, athletic man is brought to your emergency department by ambulance after he experiences sudden-onset shortness of breath. He’s tachypneic but not has otherwise normal vital signs upon examination. You’re not sure if you hear breath sounds on one side. Being the ultrasound enthusiast that you are, you Read more…
A 67-year-old man with history of COPD, HIV (CD4 50), peripheral vascular disease, DVT, and chronic renal failure presented to the ED with AMS and dyspnea after missing one dialysis session due to a transportation issue. His home attendant found him at home confused and called EMS. She reported that there was no Read more…
Here’s Dr. Carmelli with today’s Morning Report! Noninvasive positive pressure ventilation (NPPV) Definition -NPPV refers to positive pressure ventilation delivered through a noninvasive interface (nasal mask, facemask, or nasal plugs), rather than an invasive interface (endotracheal tube, tracheostomy). Indications: Younger age Lower acuity of illness (APACHE score) Able to cooperate, better Read more…
Presented by: Dr. Luke Donnelly Summarized by: Drs. Wendy Chan and Yonatan Yohannes Reviewed by: Dr. Ian deSouza The Case: 27 year-old male no PMH BIBEMS for syncopal episode in bathroom. + significant family Hx of PE. Initial vitals: HR 138, RR 33, BP 87/64, 91% 02 on room air. Read more…