Thrombolysis for MI: A Board Review Short
Mel reviews the indications and contraindications to thrombolytic therapy in acute MI.
Can Ultrasound Predict Who Will Survive After Thoracotomy?
What does ultrasound have to do with resuscitative thoracotomy? Isn’t one done with a knife and scissors while the other uses a sound wand? It turns out that ultrasound may be able to predict who will and will not survive after having their chest cracked. A study coming out in the September 2015 Annals of Surgery found that patients in traumatic cardiac arrest who had no cardiac motion and no pericardial fluid on point of care ultrasound had a zero survival rate following thoracotomy.
Nothing is perfect, not even contraception. And sometimes, there’s no contraception to speak of. Preventing pregnancy, however, doesn’t need to be complicated. Copper IUDs and oral agents like ulipristal are effective and relatively easy methods of preventing unintended pregnancy. To help make sense of it all, Jan Schoenberger and Stuart Swadron review the 2015 NEJM article Emergency Contraception
Toxic Alcohols: A Board Review Short
A review of the toxic alcohols for your board review prep.
Hypertonic Saline for HypoNatremia and Sounding: A Board Review Short
This is a board review short - when to use hypertonic saline in hyponatremia. Also a case of sounding, not for the kids but fascinating if not disturbing!
Quality Review Gets Septic
August brings part four of our conversation with Dr. Cam Berg on how his hospital standardizes, optimizes, and improves care of common conditions. This time, it’s the leviathan: SEPSIS. Reuben Strayer gives lessons hard learned from QA, while our in-house pharmacologist Bryan Hayes gives the final word on which agent is better for A. Fib rate control. Amal Mattu is back with a cardiology corner on the scoundrel of cardiothoracic life threats: aortic dissection. Weingart dissects a complex case of post ROSC airway management and paper chase digs deep into blunt trauma thoracotomy. Annals of EM, LIN sessions, clinical sobriety and so much more!
Animal Bites: A Board Review Short
A brief review of animal bites, human, dog and cat...
The new ACC algorithm for cardiac arrest
A quick look at the brand new ACC algorithm for the treatment of cardiac arrest without return of consciousness.
A Totally Rad Month Worth it's Weight in CT Scans
Sean and Stuart are back for an action packed July. How should we manage acute pericarditis? Amal Mattu has you covered. Who needs a tetanus shot and what does the booster actually do? The evidence may surprise you. What are the priorities in resuscitating a post drowning patient? We break down the steps to take and erase the background noise. David Newman deconstructs and analyzes new literature on endovascular treatment for stroke. Is there finally a therapy we can all agree on? Human trafficking victims pass through our EDs every day, but can we recognize them? More importantly, can we help them? And the paper chasers explore an abscess technique that’s been catching on across the globe.
Burning with Knowledge So Sick it Will Give You a Subdural
This June it’s all about the sun (at least in the northern hemisphere). Sunblock, kids in hot cars, and that trip to a sunny beach that ends up with you stooling your guts out from travelers diarrhea. Pediatric resuscitationist Andy Sloas gives high yield pearls on critically ill asthmatics and croupers. Is there still a role for oral contrast? An ED doc and radiologist square off in a cage match that will leave one in tears. Cam Berg acts as cat herder in chief with another accelerated diagnostic pathway: CHF. Our year long review of a chest pain medicolegal case comes to a surprise conclusion, and the paper chasers ask, “Which subdural hematoma need surgery?” It’s all here, and then some!
MET for Renal Colic
What makes renal stones fly out of your urine stream? Neither tamsulosin nor nifedipine, it appears.
A Totally Mental Month of Education!
Did you know that sitting is considered the ‘new smoking’? Not that we sit much in our profession, but something to think about when you’re in a chair punching out a bolus of dictations or EMRs. Cam Berg (the chest pain ADP guy) is back with a rational pulmonary embolism diagnostic pathway. Are there geriatric patients in your ED? Rhetorical. The Italian stallion, Al Sacchetti, goes pearl diving into the mind of an ED geriatrician. Intubating kids, curing strokes, making patients happy with text messages, and, of course, ketamine! All that, and more, in May 2015 EMRAP…
Hypothermia for Pediatric Cardiac Arrest?
A large study on hypothermic therapy for pediatric cardiac arrest just has been published online; we take a first pass.
The Poetry of Emergency Medicine
Spring is here! At least in the northern hemisphere. And what says spring more than a discussion of red, swollen, proptotic eyeballs? Cricoid pressure has not met its final repose. Swami and Minh Le Cong debate its merits and downsides. Olympic snowboarder Shaun White had Tetralogy of Fallot, but a few surgeries later- gold medal. Some kids are not so lucky and have recurrent TET spells. We discuss a novel treatment for these cyanotic emergencies. Scotty Weingart gives his opinion on endtidal CO2. Is it staph, is it strep? Bryan Hayes reviews current lit on managing soft tissue infections. LIN sessions, paper chasing and so much more.
Promise: The Latest sepsis megatrial
The latest sepsis mega-trial results are in, we take a quick look.
Early Release: Endovascular Therapy for Stroke
A few weeks ago we promised a deeper review of endovascular therapy for stroke, with Dave Newman. Dr. Newman has done his usual exceptional work and we are happy to release this to you now, before it comes out on EMRAP since the topic is so timely.
Getting Psyced About Airway Management While Dying of a Peanut Allergy
Tis March ladies and gents a time to think before you relocate, this is a strong suggestion so take it or I will lacerate your kids heads, or make you think you have a heart attack, I will make you obese and dislocate your knee, I will poison you with cyanide, if you arrest I will NOT resuscitate, I will blow warm wet oxygen up your nose and bust your pelvis and make you bleed, I will punch your kid in the neck and not CT them, ODDA know what I am talking about! All this and I will then OD you on acetaminophen, come on MAC lets score on this and just run a marathon til we poop blood...yeah is March EMRAP!
Special Edition: ADP for Chest Pain with Amal Mattu
Dr. Mattu reviews an Accelerated Diagnostic Protocol for Chest Pain based on the guidelines of the American Heart Association. This is an important topic for all Emergency Physicians and presented gratis by EMRAP.
The FAST-MAG trial
The FAST-MAG trial has just been published in the NEJM. Great to see ED docs publishing at the highest level... pity it didn't work
PROPPR Study Published Today!
The PROPPR study was published today - we give it a first look over.
MR CLEAN Trial Just Published
Another BIG stroke study just published. We give it a first pass because lots of discussion will be going on about this puppy!
It is Hard to Breathe When Your Vocal Cords Don’t Work!
It’s February and time for some infectious disease! Swami introduces the idea of discharging patients with neutropenic fever from the ED. Is he mad?! Mizuho sits down with the CDC’s leading measles epidemiologist to get the straight facts on vaccination, outbreaks and what we should do if a measles patient strolls into our department. Need to transfer a trauma patient but overwhelmed by all the details? Not to worry, Howie Mell gives his ‘“clip ‘n save” breakdown on making the process smoother than a baby’s bottom. How many things do you need to know about the patient in respiratory distress? Two! Paper chase, vocal cord dysfunction, steroids in asthma, tissue adhesive magic and so much more.
What Could be Better than Patients with Total Body Weakness that Need ECMO
It’s the start of a new year and time to get busy! Did you drink a little too much and get a hangover? Now do you feel a little weak and dizzy, like a little sick neonate with a broken heart. You may have some migrating weakness, some confusion, you feel like you had a stroke, or maybe developed endocarditis? You certainly have some ABx associated diarrhea, and your seratonin level is way too high, you feel so bad you might need ECMO but are afraid of getting sued! Yes it’s going to be a busy month.