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Syphilis - Dr. M. Noe
Syphilis is caused by an old bacterium (spirochaete bacterium Treponema pallidum) but is making a comeback, with infection rates greater than HIV in the US. Various stages of disease affect many organ...
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Pre-PICU Prep - Dr. Sean Fox
Shock: RecognitionThere is no single pathognomonic finding that defines shock.Hypotension is a late finding, but an ominous one, in kids.Constellation of findings:TachycardiaTachypneaPoor...
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Leadership in the Trauma Bay
Before the CodeConsiderHow busy is department?Staffing?Number of patients? Always wear gown, gloves, masks, shoe covers, lead gown and thyroid shield.Recognize shock!Consider:Vital SignsCharacter of...
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Carolinas Case Conference - Dr. J. Raper
Submassive Pulmonary Embolisma nefarious and cryptic diseasedefinition in our shop:lobar or greater clot burdennormotensionRight ventricular dilatation/dysfunction by CT, cardiac biomarker, or...
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Carolinas Case Conference
1. ACS in the elderly can be tricky. Presentations can be subtle with the most common symptoms being chest pain, shortness of breath, diaphoresis and nausea. Patients > 65 who present without chest...
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Management of Atrial Fibrillation in the Acutely Ill
In the acutely ill patient with rapid Afib, management should focus on quick rate controlIV diltiazem should be the treatment of choiceBolus is crucial; re-bolus is crucial – they brake the vicious...
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OrthoClass - Pediatric Elbow - Dr. S. Lawson
The basics of evaluation for elbow fractures in children are the same as adults - 2 (ideally 3) views, determine if there are any disruptions in the cortex, assess the radiocapitellar and anterior...
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Carolinas Case Conference - Dr. S. Pecevich
Bleeding AV FistulasAV Fistula vs. AV GraftFistulaSurgically connect artery to veinGoal is to increase flow and pressure into the vein for accessAbout 2-3 months to mature for useGraftForeign...
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Vertigo - Dr. A. Asimos
Our nurses should now be performing the BE-FAST screen (Balance, Eyes, Face, Arm, Speech, Time) at triage to identify possible acute stroke patients. If the screen is positive for acute onset of...
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Geriatric Trauma - Dr. S. Colucciello
Vital signs and physical exam are often unreliableUse Pulse of 90 and SBP or 110 as criteria for TCIUse Shock Index X age to identify occult shock (should be <50)Lactate is most sensitive...
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Carolinas Case Conference - Dr. K. Thomas
Thoracic injuries are common after CPR: consider evaluation for pneumothorax, hemothorax, liver and splenic injuries after ROSCConsider thoracic and abdominal injuries as a reason for hypotension...
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Cardiology Corner - Dr. L. Littmann
I. Bifascicular Block and Second Degree AV BlockIn asymptomatic individuals, chronic bifascicular block in itself does not usually require cardiac work-up; the prognosis is generally benignThe...
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Bartholin's Abscess & Vaginal FB's - Dr. A. Hunt
Bartholin AbscessGeneralBartholin’s Gland is a pea sized glands located at the 4 and 8 o’clock positions of the vaginal vestibule, tasked with maintaining moisture of the vestibular surface.Can...
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Non-Opioid Pain Control in the ED - Dr. C. Griggs
Opioid prescribing by emergency providers affects long term opioid dependency of patients Opioid prescribing for chronic pain has poor evidence for improved functional outcomes of pain or...
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Carolinas Case Conference - Dr. K. Thomas
1. HSV Encephalitis has significant morbidity and mortality, during your history ask about Maternal AND Paternal history of HSV.2. You should cover for HSV meningitis with acyclovir...
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Carolinas Case Conference - Dr. S. Pecevich
Large MCA Strokes* Although headache is less common in ischemic stroke, the presentation may be deceiving. Some patients with large vessel occlusion will mimic signs of hemorrhagic stroke--headache,...
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Carolinas Case Conference - Dr. S. Lawson
Working in a pediatric ED isn't just diagnosing viruses - child abuse/neglect is more prevalent than we'd like to think:2-10% of children presenting to the ED are victims of abuse or neglectchildren...
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Angioedema - Dr. M. Reaven
1. Several types of angioedemaAcute allergic/AnaphylacticACE-inhibitor inducedHereditary AngioedemaAcquired2. Each has a different treatmentAcute allergic/Anaphylactic - Epinephrine, steroids,...
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Sickle Cell Disease in the ED - Dr. Ify Osunkwo
Pathophysiology of SCD is complex, VOC, inflammation, endothelial dysfunction, clotting etc. Treatment should address all aspects of pathophysiologyAll pain in SCD is not SCD VOC pain – they can get...
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A Rational Approach to PEA - Dr. L. Littmann
1. Most common “mechanical” causes:Cardiac tamponade (including STEMI and myocardial rupture)Tension pneumothoraxMassive PE 2. Most common “metabolic” causes:Severe hyperkalemia with or without...
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