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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Bougie-Aided Cricothyrotomy

  A great video discussing   Bougie-Aided Cricothyrotomy By Darren Braude   Originally posted on the EMCrit blog by Scott Weingart     Want to read more…?              

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Mmmm….spicy

    A 22 year old male present to the ED with complaints of generalized flushing of the skin and associated urticaria which began within 20 minutes after he began eating at a new Sushi restaurant. Upon arrival he is diaphoretic, nauseated and dizzy with tingling to his lips and …

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Clinical Case: shortness of breath

  A 47 year-old female presents to the ED via basic life support ambulance with sudden onset of severe dyspnea after a witnessed choking episode while taking her daily medications. On arrival: Morbidly obese female sitting upright in the stretcher with a non-rebreather mask. She appears diaphoretic with severe dyspnea …

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I & D with no P ?

  Is routine packing of simple cutaneous abscesses necessary? This article suggests that it may be time to abandon the “that’s-the-way-we-do-it” mentality for abscess drainage.         On the topic of I&D, this next article discusses Minimally Invasive Technique in Treatment of Complex Subcutaneous Abscesses in Children. In …

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Visual Diagnosis # 2

  A 62 year old woman present to the emergency department with complaints of excruciating pain and swelling to her left leg over the past few days. She denies any history of trauma. Her PMHx is significant for a newly diagnosed metastatic non-small-cell lung cancer. Symptoms began 4 days ago …

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Figure 1 – Image of the Week # 1

  This photo was taken during a thromboendarterectomy for treatment of chronic thromboembolic pulmonary hypertension (CTEPH). Surgery is the only definitive therapy for this condition, which occurs in a small proportion of acute pulmonary embolism patients.                 Photo credit: Sean Love/Figure 1 Medical …

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Visual Diagnosis #1

A 40-year-old male reported to the emergency department with complaints of pain and swelling under the left eye and an ulcer on the roof of his mouth for the past 2 weeks. Pain was gradual in onset with swelling over the left maxillary sinus now causing nasal obstruction and edema …

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Ketofol: Are you ready for change?

            The ideal pharmacologic agent for procedural sedation and analgesia would provide an adequate level of sedation while minimizing pain and anxiety, maximizing amnesia, minimizing the potential for adverse drug-related events, controlling behavior, and maintaining a stable cardiovascular and respiratory status. Sound like the Holy …

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