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ETOH Withdrawal - Dr. Snow
Always consider withdrawal in your undifferentiated agitated delirium patients! The pathophysiology of AWS (alcohol withdrawal syndrome) is complicated, but simply stated involves down regulation of...
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1. Consider plain film imaging early in cases of suspected bowel obstruction2. Involve surgical consultation early and get a lactate to evaluate for signs of bowel ischemia
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Case Conference Core Concepts - Dr. Lounsbury
Consider syncope as a differential diagnosis of seizure activityGI bleed can present with AMS, rectal exam should be doneThe present presentation is often dependent upon the past... don't overlook the...
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Epistaxis - Dr. Mollo
RED FLAGSPatients on full dose anticoagulants (eg, warfarin or heparin infusion)Patients who continue to bleed despite two good attempts at nasal packingTrauma patients - internal anatomy may be...
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Advanced Strategies in Non-invasive Ventilation - Dr. Pearson
1. Understand non-invasive ventilation settings:Mode: pressure supportTrigger: patient-initiated onlyIPAP (Inspiratory Positive Airway Pressure) = VentilationEPAP (Expiratory Positive Airway...
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Carolinas Case Conference - Dr. Goode
1. When resuscitating DKA patients, avoid chloride-rich fluids as to not worsen acidosis.2. Fight the urge to give bicarb! It does not address the pathophysiology of DKA and will likely harm the...
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Pregnancy Over 35 - Dr. Pelucio
Advanced Maternal AgeSocietal impact of pregnancy in advanced maternal ageRisks of infertility and dangers delaying reproduction are rarely taught even at college or professional graduate levelOlder...
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Carolinas Case COnference - Dr. Mollo
When approaching patient's with vague neurological symptoms, try to localize a lesion or overriding, unifying pathology that could explain the process.Be prudent to identify objective neurological...
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The Opioid Epidemic - Dr. Griggs
Patients with chronic pain are at higher risk of opioid misuse, including dose escalation and self medication of negative emotions.Responsible opioid prescribing in the ED entails maximizing the use...
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Submersion Injuries - Dr. Awad
Prompt rescue, bystander CPR, and cerebral reperfusion/oxygenation are most important for survival.Hypoxia and Acidosis are main mediators of injury, and most important to treat.No cervical collar...
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The ST Segment - Dr. Garvey
1. Be wary of ECG Early Depolarization (ER) pattern limited ONLY to the inferior limb leads. ER is most typically found in anterolateral precordial leads, and may extend to inferior leads...
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TIA in 2016 - Dr. Asimos
None of the current short term risk stratification tools for TIA perform well enough to identify patients for outpatient versus pre-discharge work-up.Large artery atherosclerosis (usually carotid...
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Transvenous Pacing - Dr. Pecevich
Transcutaneous pacing: painful, difficult, complicates things. Needs 10x the milliamps.Don’t get behind -- concerned about an MI? Mortality can be significant! -- fatal bradycardiaPlace the sheath (6...
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Carolinas Case Conference - Dr. Goode
In the management of Submassive and Massive PE:Emergency physicians can reliably perform and interpret goal-directed echocardiogram to diagnose RV strain...so do it.Avoid positive pressure...
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Case CONFERENCE - Dr. Lounsbury
• PID is a common disease amongst young women and has a wide variety of clinical presentations• PID is a rare but known cause of small bowel obstruction in adolescents• Beware the sterile pyuria•...
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Lipid Rescue - Dr. Kerns
Utilize bedside and invasive monitoring to assess the source of drug-induced shockVasoplegiaImpaired contractilityBothTailor resuscitation based on the individual patient’s altered physiologyImpaired...
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Case Conference Core Concepts - Dr. Lounsbury
• Give epinephrine early and in the correct dose for anaphylaxis • Be prepared for the difficult airway in all cases of severe anaphylaxis• There are no contra-indications to epinephrine...
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Give a Memorable Presentation - Dr. Gibbs
There are two phases to the development and presentation of a "memorable lecture": (1) preparation, (2) delivery.Elements of PREPARATION include:a. Picking the right topicb. Mastering the...
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Trauma Cases Core Concepts - Dr. Gibbs
1. Only 10% of injured patients are initially managed at regional Trauma Centers2. Community hospital emergency physicians play a pivotal role in the management of acute injury3. Over-testing...
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Pathophysiology of blast injury - Dr. Kallgren
1. Primary injury - overpressure from blast waves - air-containing organs most susceptible to injury - damage to lungs (pulmonary blast injury) most common injury to immediate survivors2....
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