A Rare Intervention for an Unusual Exposure
​Children like to put things in their mouth, ears, nose, and eyes. A 9-year-old boy superglued his right eye shut and came to our pediatric emergency department. He thought the glue was an over-the-counter eye lubricant and filled his entire eye with the glue.​​Overdoses and poisonings are a dangerous threat to children. In fact, unintentional poison overdose or ingestion has continued to claim hundreds of children's lives. More than 300 children in the United States ages 0 to 19 are seen at EDs for poisoning and two of them die each day. (CDC. April 28, 2016; http://bit.ly/2kjVmhO.)Not all toxic exposures a...
Source: The Procedural Pause - March 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A Rare Intervention for an Unusual Exposure
​Children like to put things in their mouth, ears, nose, and eyes. A 9-year-old boy superglued his right eye shut and came to our pediatric emergency department. He thought the glue was an over-the-counter eye lubricant and filled his entire eye with the glue.​​Overdoses and poisonings are a dangerous threat to children. In fact, unintentional poison overdose or ingestion has continued to claim hundreds of children's lives. More than 300 children in the United States ages 0 to 19 are seen at EDs for poisoning and two of them die each year. (CDC. April 28, 2016; http://bit.ly/2kjVmhO.)Not all toxic exposures are i...
Source: The Procedural Pause - March 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Solutions for Difficult Problems:Eye Irrigation — Morgan Lens No More! Part 2
We promised you short, sweet, and simple solutions, and we plan to deliver. Many of the tools we want you to use may have merely been forgotten. The steps to complete these simple solutions will require just a few minutes of brushing up on the basics while watching our how-to videos and reading our step-by-step blog posts.One of the lengthiest procedures in the emergency department can be eye irrigation. Some patients may need 5-15 liters of normal saline flush, which can take hours. Alkaline products need ample flushing and constant reevaluation with pH checks to avoid ocular burns. Patients can get frustrated and often t...
Source: The Procedural Pause - October 3, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

LITFL Review 238
Welcome to the 238th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Radiopaedia has the entire SMACC Radiology playlist available to view. All cases, discussion notes—everything! Awesome #FOAMed. [SO]   The Best of #FOAMed Emergency Medicine Sydney HEMS have just released a wealth of superb Pre Hospi...
Source: Life in the Fast Lane - July 3, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

LITFL Review 237
Welcome to the 237th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week More great reflections on SMACCDub, this time from Bishan Rajapakse and from Celia Bradford. DasSMACC is not to be missed… [SO] The Best of #FOAMed Emergency Medicine tPA without a NCHCT first? Insanity you say? Read EM Lit of Note’s post t...
Source: Life in the Fast Lane - June 26, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Longing for the QT
A 58-year-old man presented to the ED with a reported overdose of an unknown medication. The patient was agitated, combative, and altered. Initial vital signs included a heart rate of 115 beats/min, blood pressure of 154/93 mm Hg, respirations of 22/min, and temperature of 99.5°F. The patient was difficult to evaluate because he was agitated, and he was given 5 mg of haloperidol IV and 2 mg of lorazepam IV. The patient continued to be agitated, and was given another 10 mg of haloperidol IV, followed by a repeat dose of 10 mg IV 15 minutes later. The patient then became unresponsive, and his cardiac monitor demonstrated th...
Source: The Tox Cave - March 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A Nefarious Character with an Agenda
Every new advanced nurse practitioner, physician assistant, or resident gets his fair share of complex emergency department procedures during training. Seasoned providers, however, are just as excited to place a central line in a septic patient, LP a "rule-out meningitis," or swiftly fix a nursemaid's elbow.This month we hope to remind you of a few sweet and satisfying procedures that take only moments to do. Your skill in completing these procedures is imperative. Not only will you amaze your patient, but you'll shorten your door to dispo-time.The StyeThe stye is a nefarious character with an agenda. It starts o...
Source: The Procedural Pause - February 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Test your medicine knowledge: 84-year-old man with cough and nasal congestion
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. An 84-year-old man is evaluated for a 5-day history of rhinitis, nasal congestion, sneezing, and nonproductive cough. The symptoms began with a sore throat, which resolved after 24 hours. He has mild ear pain when blowing his nose or coughing. He has a history of coronary artery disease and hypertension. Medications are aspirin, metoprolol, and hydrochlorothiazide. On physical examination, temperature is 36.5 °C (97.7 °F), blood pressure is 130/72 mm Hg, pulse rate is 82/min, and respiration rate is 16/min. He...
Source: Kevin, M.D. - Medical Weblog - September 5, 2015 Category: Journals (General) Authors: Tags: Conditions Primary care Source Type: blogs

Dabbling in Dentistry
Most people will experience dental pain or a dental complication at some point in their lives. Dental pain is an incredibly common complaint by people of all ages, especially those who lack dental insurance and suitable hygiene habits. Sometimes, though, poor dentition or injury is simply a result of bad luck. Patients often present to the ED hoping to find a dentist and an answer to their problems.   Your first thought? “I am not a dentist. What am I going to do?” You’re right to an extent. We are not dentists, and often feel we have little to offer patients for acute issues that require equipment we don’t have...
Source: The Procedural Pause - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Dabbling in Dentistry
Most people will experience dental pain or a dental complication at some point in their lives. Dental pain is an incredibly common complaint by people of all ages, especially those who lack dental insurance and suitable hygiene habits. Sometimes, though, poor dentition or injury is simply a result of bad luck. Patients often present to the ED hoping to find a dentist and an answer to their problems.   Your first thought? “I am not a dentist. What am I going to do?” You’re right to an extent. We are not dentists, and often feel we have little to offer patients for acute issues that require equipment we don’t have a...
Source: The Procedural Pause - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Increased Heart Risk Linked To Popular Antibiotic
Acute use of the popular macrolide antibiotic clarithromycin has been linked to a small but significant increase in cardiac death. In a report in the BMJ, researchers in Denmark analyzed the effects over a 14-year period of the acute use of penicillin V, roxithromycin, and clarithromycin. Earlier research raised concerns that marcrolide antibiotics in general, and erythromycin and azithromycin in particular, might prolong the QT interval and increase the risk for fatal arrhythmias. In the new study, clarithromycin was associated with a significant increase in the rate of sudden cardiac death compared with the other...
Source: CardioBrief - August 20, 2014 Category: Cardiology Authors: Larry Husten Tags: Heart Rhythms Policy & Ethics Prevention, Epidemiology & Outcomes antibiotics arrhythmias clarithromycin QT interval Source Type: blogs

Funny Allergy Quotes, Jokes, Stories and a List of Crazy Reactions.
If you're looking for funny allergy quotes, jokes and stories you've come to the right place.  I asked my readers from facebook to provide me with their experiences they've had regarding crazy allergy reactions and they did not let me down.  They relayed dozens of incidents they've experienced through the years.  Over the years I've discovered several  funny allergies myself, including allergies to prednisone, diet products and the color red.  Some patients have dozens of allergies.   My experience is that most of these allergies are not allergies in the physiological sense.   The te...
Source: The Happy Hospitalist - July 2, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs