Funtabulously Frivolous Friday Five 128
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia…introducing Funtabulously Frivolous Friday Five 128
Question 1
Melena suggests a proximal GI bleeding source in which there is time for enzymatic breakdown to transform blood to melena. How much blood in the stomach does it take to cause melena?
+ Reveal the Funtabulous Answer
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50mL
In clinical experiments, placing as little as 50 mL of blood in the stomach can cause...
Source: Life in the Fast Lane - December 4, 2015 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five button batteries EMLA Essex-Lopresti injury melena methaemoglobinaemia morel-lavallee lesion Source Type: blogs
Don't Be Blue
A 21-year-old woman presented with a sore throat, low-grade fever, body aches, swollen glands, and generalized malaise for three days. The patient said her symptoms had worsened over the past day. She denied any difficulty breathing but endorsed pain and difficulty swallowing.
Her initial vital signs were blood pressure 132/84 mm Hg, heart rate 113 bpm, respiratory rate 22 bpm, temperature 100.4°F, and pulse oximetry 100% on room air. She was diagnosed with a peritonsillar abscess, and the EP applied a topical anesthetic to the area prior to draining it. During the procedure, the patient’s pulse oximetry dropped to 8...
Source: The Tox Cave - November 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Don't Be Blue
A 21-year-old woman presented with a sore throat, low-grade fever, body aches, swollen glands, and generalized malaise for three days. The patient said her symptoms had worsened over the past day. She denied any difficulty breathing but endorsed pain and difficulty swallowing.
Her initial vital signs were blood pressure 132/84 mm Hg, heart rate 113 bpm, respiratory rate 22 bpm, temperature 100.4°F, and pulse oximetry 100% on room air. She was diagnosed with a peritonsillar abscess, and the EP applied a topical anesthetic to the area prior to draining it. During the procedure, the patient’s pulse oximetry dropped to...
Source: The Tox Cave - November 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Research & Reviews in the Fastlane 104
Welcome to the 104th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check ou...
Source: Life in the Fast Lane - October 15, 2015 Category: Emergency Medicine Authors: Soren Rudolph Tags: Airway Anaesthetics Education Emergency Medicine Emergency Medicine Update Haematology Immunology Infectious Disease Intensive Care Pre-hospital / Retrieval R&R in the FASTLANE Resuscitation Trauma critical care Review Source Type: blogs
Tap that Knee! Basics of Arthrocentesis
Part 2 of a Series
Our series on joint care has given you a basic overview on knee arthrocentesis. Typically, it is not necessary to have an orthopedic consultant come to the bedside in the emergency department to do this procedure. Arthrocentesis is a procedure you can do well and feel confident about your technique.
Take a moment to review our last blog post on knee pain before reading this post and watching the accompanying video. (http://bit.ly/1Q7dG4h.) As always, review the anatomy; it plays a key part in successful bedside technique. Ultrasound-guided arthrocentesis is always a favored approach.
Although em...
Source: The Procedural Pause - October 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Tap that Knee! Basics of Arthrocentesis
Part 2 of a Series
Our series on joint care has given you a basic overview on knee arthrocentesis. Typically, it is not necessary to have an orthopedic consultant come to the bedside in the emergency department to do this procedure. Arthrocentesis is a procedure you can do well and feel confident about your technique.
Take a moment to review our last blog post on knee pain before reading this post and watching the accompanying video. (http://bit.ly/1Q7dG4h.) As always, review the anatomy; it plays a key part in successful bedside technique. Ultrasound-guided arthrocentesis is always a favored approach.
Altho...
Source: The Procedural Pause - October 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
A Procedure’s Impact on Patient Comfort, Care, and Outcome
This blog teaches procedures, with its case studies and videos intended to help you perfect your technique and strengthen your confidence. This month we explore issues related to procedural patient impact. How will your intervention positively or negatively affect patient outcome? What happens when we decide to step in and complete a procedure?
A risk is always inherent when a provider undertakes a procedure, no matter how insignificant. Carefully, we weigh the pros and cons of the potential procedure with our patients. Will our intervention cause a positive effect or outcome? Our goals are to repair, resolve, or restor...
Source: The Procedural Pause - August 3, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
A Procedure’s Impact on Patient Comfort, Care, and Outcome
This blog teaches procedures, with its case studies and videos intended to help you perfect your technique and strengthen your confidence. This month we explore issues related to procedural patient impact. How will your intervention positively or negatively affect patient outcome? What happens when we decide to step in and complete a procedure?
A risk is always inherent when a provider undertakes a procedure, no matter how insignificant. Carefully, we weigh the pros and cons of the potential procedure with our patients. Will our intervention cause a positive effect or outcome? Our goals are to repair, resolve, or rest...
Source: The Procedural Pause - August 3, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management
A young woman presented with intermittent shocks from her implantable defibrillator. She was intermittently unconscious and unable to give history. The monitor showed intermittent polymorphic ventricular tachycardia. The physician was presented with this ECG at the same moment he was observing the repeated syncope:Time zeroIt is a bigeminal rhythm with a very bizarre PVC. The PVC has an incredibly long QT, but the intervening native rhythms do not. However, when I saw this (it was texted to me), it immediately reminded me of this case, so I knew by sheer recognition that it was lo...
Source: Dr. Smith's ECG Blog - July 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
A Patient's Lie Masks the Cause of Chest Pain
A man in his 30s comes to your emergency department at 3 a.m. profoundly diaphoretic and reporting severe 10/10 chest pain. He has been at a party all night, and the chest pain started about 30 minutes earlier. He had a previous heart attack, but cannot remember many of the details. He reports no medication or drug use. No doubt this is a concerning presentation, and you immediately order an ECG, blood work, and an aspirin.
While this is in process, you review the electronic medical information, which reveals that the previous “heart attack” was actually observation for chest pain rule-out. The ECG showed nonspeci...
Source: Spontaneous Circulation - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
A Patient's Lie Masks the Cause of Chest Pain
A man in his 30s comes to your emergency department at 3 a.m. profoundly diaphoretic and reporting severe 10/10 chest pain. He has been at a party all night, and the chest pain started about 30 minutes earlier. He had a previous heart attack, but cannot remember many of the details. He reports no medication or drug use. No doubt this is a concerning presentation, and you immediately order an ECG, blood work, and an aspirin.
While this is in process, you review the electronic medical information, which reveals that the previous “heart attack” was actually observation for chest pain rule-out. The ECG showed nonspecifi...
Source: Spontaneous Circulation - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Wide Complex Tachycardia Refractory to Anti-dysrhythmics and Cardioversion.
This was contributed by Rebecca Kornas, MD, one of our EM Residents. Edited and commented upon by Smith.A middle-aged male with a history of CAD and two vessel CABG and ischemic cardiomyopathy (EF 20%) presented to the emergency department (ED) after an out-of-hospital cardiac arrest. Paramedics found him in ventricular fibrillation and started mechanical CPR via the LUCAS device, five rounds of epinephrine, and delivered six unsuccessful defibrillation attempts before arriving in the ED. He was defibrillated into a wide complex rhythm. There was no pulse. Che...
Source: Dr. Smith's ECG Blog - June 3, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
The Hugest of the Huge Hematomas
Welcome to our new series, “Guts and Gore.” That title should serve as a warning that some of the videos we will use as teaching tools may be controversial and not for weak stomachs. We hope, however, that part of why you became an emergency provider was to handle sticky situations like the ones we will present. People like us have the ability to ignore blood and copious discharge, and instead focus on saving and improving the lives of our patients. Rarely are you thanked for this ability, and we hope this series on guts and gore will improve your technique, even when the going gets tough.
The Approach
n Proper i...
Source: The Procedural Pause - June 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Hugest of the Huge Hematomas
Welcome to our new series, “Guts and Gore.” That title should serve as a warning that some of the videos we will use as teaching tools may be controversial and not for weak stomachs. We hope, however, that part of why you became an emergency provider was to handle sticky situations like the ones we will present. People like us have the ability to ignore blood and copious discharge, and instead focus on saving and improving the lives of our patients. Rarely are you thanked for this ability, and we hope this series on guts and gore will improve your technique, even when the going gets tough.
The Approach
n Proper iden...
Source: The Procedural Pause - June 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
