ECG Quiz # 3

    A 16 year old boy presents with a recent history of increased dyspnea and palpitations on exertion as well as intermittent dizziness and chest heaviness during football practice. He states he was at practice today and felt very weak and lightheaded and almost passed out while running down …

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Don’t cut my precious….

    There are many ways to remove rings from injured swollen digits. We’ve all heard about using soap, vaseline, ice, dental floss, surgical lubricant and even Windex. When those methods are unsuccessful, our last resort is to cut the ring removing it from the digit. Here’s a useful video …

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Umbilical Vein Catheterization

  During the resuscitation of a critically-ill newborn who requires vascular access, umbilical vein catheterization can be a life-saving procedure. The umbilical vein can remain patent for approximately 1 week after birth and when catheterized, allows the administration of fluids and medications. Contraindications to the procedure include necrotizing enterocolitis, omphalitis, …

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ECG Quiz # 2

    A 19 year old male is brought in for evaluation by his mother after a syncopal episode. He was packing boxes getting ready to return to school after the long summer when he felt suddenly light-headed with associated palpitations. His mother heard a “thump”and found him in his …

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Mmmm…….Burns So Good

    There were over six thousand cases of laundry pod exposures reported to poison centers around the nation in 2012. The majority of the exposures were in children under 5 years old. Ninety percent of the pod-related poisonings were from ingesting the detergent. The most common symptoms from exposures …

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Visual Diagnosis # 6

    A mother brings her 5 year old son in for evaluation of fever and rash which have persisted over the past 6 days despite acetaminophen and ibuprofen. He has had a mild cough without shortness of breath. He complains only of a sore throat and left ear pain. …

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Ultrasound in Plantar Fasciitis

    Plantar fasciitis is the most common cause of heel pain presenting to the emergency department. Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed.       In this age of ultrasound we can now make this …

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this Krokodil will bite !

      Krokodil (pronounced crocodile), thought to have originated in Russia about 10 years ago, is not new to the drug seen but it is definitely worth talking about. A quick google search, will immediately reveal the horrific physical effects this drug has on those foolish enough to use …

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Own the Resus !

   This is an excellent lecture which was originally presented at the 2012 Essentials of Emergency Medicine conference presented by Dr.Cliff Reid           from         Thank you to Mel Herbert from EM:RAP for making this available. Intro. by Scott Weingart from EMCrit   …

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Visual Diagnosis # 5

                      A 46 year old male presents with complaints of sore throat and difficulty swallowing over the past 5 days. He described subjective fevers over the past 2 days which he related to a recently infected lower molar which has …

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Listen to Me !

       It’s been said that Greg Henry is a “modern-day Socrates, Plato, and Ben Franklin all rolled into one.” Many others state that he is one of emergency medicine’s “preeminent philosophers and educators” and describes his style as “in-your-face eloquence.”  This lecture is a “must-listen” for all emergency …

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Visual Diagnosis # 4

    A 10-year-old boy presents is brought in with complaints of right eye pain and double vision. The patient claims he ran into a classmate while playing football after school one week ago. He denies any loss of consciousness at the time of the accident. He denies headache, vomiting, …

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Rave or Die !

    The drugs which had historically been largely associated with ‘Rave’ parties over the past 20 years: LSD, MDMA, GHB, Meth and Ketamine are now being replaced by new and sometimes more deadly designer drugs. Recognizing the street names and being familiar with the clinical presentations may help you …

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Cervical Injection for Migraine

    Cervical Injection for Migraine Cervical injection for chronic migraine, neck pain or maxillofacial pain can be beneficial. Why this works is unclear, but it is thought to involve the trigeminal caudate nucleus which acts as a relay center. The retrospective chart review: Treatment of headaches in the ED …

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Digital Intubation

    ~ Tricks of the Trade ~ Tactile or Digital Intubation seems to be a lost art which has been forgotten in this age of video laryngoscopy. On the May 2013 episode of EM:RAP, Dr. Patrick Shipsey reminds us that digital intubation can be used as a blind intubation …

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Visual Diagnosis # 3

    A 34 year old male presents with general malaise which has been worsening over the past three weeks. He is a painter and admits to working very long days over the past 2 months. He says “my wife thinks I’m just working too much. But I just feel very …

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The RAMP

  ~ Tricks of the Trade ~ When discussing proper technique for endotracheal intubation, we often emphasize ear to sternal notch positioning. Especially in the obese patient, this technique will maximize visualization and improve the mechanics of ventilation. In obese patients and select anticipated difficult airways I often see this …

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Perimortem C-section

    The pregnant uterus consumes a large amount of maternal blood, causing gravid women to become anoxic more quickly during a crisis. A perimortem c-section delivery should be performed within 4 minutes of maternal cardiac arrest to maximize survival chances for both the fetus and mother.     Why …

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