In this blog post and podcast we take a look at the PARAMEDIC-2 trial and discuss the implications this study has on the use of epinephrine in out of hospital cardiac arrest.
Read MoreThe ADRENAL trial was a large, multicountry study assessing the utility of steroids in septic shock. Check out our review of the article here.
Read MoreSpontaneous intracerebral hemorrhage (ICH) accounts for 10-15% of all strokes and affects ~65,000 patients annually in the US. The diagnosis may not be complicated, but the optimal treatment strategy can be a moving target. What is the current recommended blood pressure to limit hematoma expansion? Should we reverse anti-platelet medications? How about seizure prophylaxis? In this feature film, Dr. Siket reviews the evidence behind the optimal management of spontaneous ICH.
Read MoreApril’s journal club looked at four clinical questions regarding the diagnosis and expectant course of renal stones. Can the STONE score help you determine if your patient’s flank pain is due to a renal stone? Which is better to confirm your clinical suspicion of a renal stone, ultrasound or CT? How likely will your patient’s kidney stone pass spontaneously? What is the accuracy of hematuria to predict a renal stone in the patient with flank pain?
Read MoreHow we deal with the Opioid Epidemic in the Emergency Department has been a topic of hot debate. We sat down with addiction medicine specialist Dr. Ken Starr to discuss buprenorphine use in the Emergency Department.
Read MoreHypotensive patients requiring volume resuscitation are a regular occurrence for emergency physicians. Clinicians are often faced with determining whether patients will respond favorably to IV fluids both before and during vasopressor administration. The ability for point of care ultrasound (including assessment for B lines and IVC collapsibility) to predict volume status and fluid responsiveness has mixed evidence. Here we explore the velocity time integral (VTI), a measurement that can be coupled with a passive leg raise to more accurately assess for true fluid responsiveness.
Read MoreCoding patients in the community setting is difficult given constraints of man power, specialists, equipment, and other resources. Knowing how to code a patient well in the community is a skill all EM practitioners should master. In this post we review the priorities and pitfalls of coding in the community, with our guest Salim Rezaie.
Read MoreThe statistics on physician suicide are frightening. Each year approximately 400 physicians commit suicide. That is more than one per day and roughly the equivalent of two entire classes of graduating medical students. Suicide accounts for 26% of deaths among physicians aged 25-39 - more than twice (11%) that of same age group in the general public. When screened, approximately 10% of medical students and physicians report current suicidal thoughts. Why are these numbers so high in the medical profession? Dr. Casey MacVane helps shed some light on this neglected crisis and what we can do to help our suffering colleagues.
Read MoreEmergency medicine physicians have a love affair going on with ketamine for its versatility. In this post we discuss the optimal use of subdissociative dose ketamine (SDK) for analgesia as an alternative to opioids, with our guest Sergey Motov (@painfreeED).
Read MoreThe evaluation of a child for non-accidental trauma (NAT) is an infrequent, yet high risk endeavor for emergency physicians. Abusive head injury is the most common cause of death in cases of non-accidental trauma and up to 30% of cases of child maltreatment are misdiagnosed at first health care contact. There is a growing body of literature that helps to frame the workup and risk stratification of children at risk for NAT. This month’s journal club focused on 3 articles centered on risk factors and diagnosis of abusive injuries.
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