Elevated Lactate in Asthmatics
You’re treating an asthmatic 22-year-old. You give 5 back-to-back nebs, steroids and mag. When you reassess, she’s moving air better with minimal wheezing, but more tachypneic. Additionally, her...
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Name That Rash!
A) B) C) D) A) German Measles (Rubella): starts on face; pruritic; complications: infection during first 4 months pregnancy high risk for congenital rubella syndrome; supportive care B) Measles...
View ArticleTurn off That Alarm!
You’re peacefully writing a note when you notice an incessant beeping from the back of your resus bay. It’s not a monitor, it’s a ventilator. What do you do? Press the silence button? Call...
View ArticleAlumni Follow-up with Kit Tainter
by @benazan I recently caught up with Kit Tainter, 2011 SinaiEM grad. He’s now doing critical care in San Diego with both ICU and ED time, many people’s dream. Hear how he got there, his advice for...
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Name That Poisonous Beast! (part 1)
This week’s pearls is a series on “Name that Poisonous Beast!”. So, let’s start. Name this poisonous beast: A) And its 8-legged colleague: B) A) Brown Recluse spider (Loxosceles): cytotoxic,...
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Name That Poisonous Beast! (part 2)
It’s part 2 of “Name that Poisonous Beast!”. Here we go! Name this poisonous beast! A) And his slithery friend… B) And what about this guy? C) A) Rattlesnake (pit viper) [Crotalinae]: venom with...
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Name That Poisonous Beast (part 3)
Part 3 of “Name that Poisonous Beast” is ocean-themed. Name this poisonous beast! A) And it’s floaty colleague: B) A) Barracuda contaminated with Ciguatoxin (from Gambierdiscus toxicus, a...
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Name That Poisonous Beast! (part 4)
It’s the final part of “Name that Poisonous Beast!”. Today, we’re going to take a walk in the garden. Name this poisonous beast! A) And it’s seedy neighbor: B) A) Death cap mushroom (Amanita...
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No Plasmalyte in Cms Sepsis Bundle: Does This Matter?
CMS recently produced a new sepsis measure/bundle that has many EM and critical care docs up in arms. I’m not going to focus on their definition of sepsis (save your rage for later), but instead on...
View ArticleA Pain in the Back – Do Patients Need More Than Nsaids?
A recent double-blinded, RCT from JAMA investigated the relative efficacies of naproxen + placebo, naproxen + cyclobenzaprine and naproxen + oxycodone/acetaminophen on functional impairment in acute...
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