Hyperglycemia
Here are some resources for hyperglycemia based on our session today. First here are RMC’s DKA protocols for adults and pediatric patients. DKA Protocol_2016.06.11 Peds DKA guidelines final 2013 Then some videos (old and new) about DKA and HHS. 2013 DKA and HHS These video review diabetic ketoacidosis and hyperglycemic hyperosmolar states. The second one…
Resuscitative Hysterectomy aka Peripartum C-Section
I hope I never ever have to do this, but these people at the Essentials of EM conference make it look easy. I think this is worth watching. Some points I took away from the video: This is a resuscitative delivery. It is meant to save the mother. The fetus and uterus are diverting a…
Idiot’s (Me) Guide to MRI
Whenever the Neurology team comes down and starts asking for special MRI scans with T2-this and gadolinium that, my eyes usually glaze over. So here’s a very brief guide to MRI’s. Very brief. General Principles The MRI works by applying a magnetic field to the body. This magnetic field aligns the protons in water nuclei. Next, external…
Posterior Reversible Encephalopathy Syndrome (PRES)
At last month’s mortality and morbidity conference, we discussed a case of Posterior Reversible Encephalopathy Syndrome (PRES). Our consultant, a neuro-intensivist, told us that PRES is not always posterior, not always reversible nor always presenting with encephalopathy. Thanks whoever named that syndrome. The presentation is extremely variable. Typically presenting with: headache, altered mental status, visual…
Bougie’s Galore
Here are some great videos on how to use bougies. Intubation with bougies Scott Weingart… yes, yes, but his video is good. Shows a preloaded bougie, which is what we should probably be doing. Has some great trouble shooting techniques Bougie cric Darren Braude’s video. A different view of the whole thing. I like this…
Stroke or Vestibular Neuritis? Use the HINTS
The other day, Tom and I had a patient with the symptom of continuous vertigo. This is to be distinguished from someone with episodic triggered vertigo, such as when turning their head to the right, which we associate with benign paroxysmal positional vertigo (BPPV). The differential for continuous vertigo includes vestibular neuritis (a relatively benign…
EKG of the week
Okay, it’s been a while since I posted anything, but here’s a quick one. This is a 30 year-old person who presents to the ED with palpitations. What is it? Here’s the EKG.
The Dental Box
Dental fractures are always fun. Luckily we have a Dental Box available in the Emergency Department. Here are some instructional videos shown today. These will be stored in Pod A. Thanks to Dr. Vishnu Pandurangadu for the inservice on these tools and theDentalBox.com for the videos.
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EKG Of The Week
This is a 31 year-old male who presented with palpitations. He said this has happened to him several times in the past. What is going on in this EKG and what would you do to fix it (if anything)? Here's his EKG: 2017-08-08
Answer on Twitter.