Meningitis

Author: Dr. Trevor Landas Defined as inflammation of the meninges, or covering layers of the central nervous system, meningitis has a high morbidity and mortality if not identified and treated promptly. The incidence is approximately 1.38 per 100,000 people. Clinical Presentation: Presenting symptoms include the classic triad of fever, neck stiffness, and altered mental status,

Migraine Cocktail: over IV fluids or neat?

Author: Dr. Calloway Pichette Article: IV Fluids for the treatment of Emergency Department patients with migraine headache: a randomized controlled trial  Background: Headache, a common complaint in the ED. Many times a day we see patients with migraine headaches in the ED. Give them a migraine cocktail (sadly, no martinis involved…) and then viola! They

COPD

COPD is one of the more common respiratory issues we encounter in the ED. It affects approximately 5% of the US population and is the 3rd leading cause of death and 12th leading cause of morbidity in the US.

Sickle Cell Fever

Basics First off…what is sickle cell anemia? Who gets it? What does the spleen even do?? Calm down, we’ll get to all of that. Let’s start with. The. Basics. So… sickle cell anemia is an autosomal recessive disease that results in a mutation in the Beta chain of hemoglobin, resulting in an amino acid change

NSTEMI, STEMI, ACS

Author: Catherine Buckley MD There are about 8 – 10 million ED visits with the chief complaint of chest pain per year in the US. (Owens et al.)10 billion dollars are spent on chest pain, 10% of which goes to the work up for ACS diagnosis. Yet somehow despite these millions we still miss 1-2%

Central Line Placement

Author:  Lauran Wirfs

Background:

Central venous access is an important procedure for critically ill patients. One consideration when placing a venous catheter is the risk of catheter-related bloodstream infections (CRBIs), which can be a significant cause of morbidity and mortality in hospitalized patients. In 2012, there were 15 million central venous catheter (CVC) days per year in the US in ICUs, and the rate of infections per catheter days is 3/1000. This post looks at a systematic review done by Marik et. al. that examines CRBIs among internal jugular, subclavian, and femoral central venous sites.

Wide Complex Tachycardia

Intro

There’s an old adage that wide complex tachycardia is VTach until proven otherwise. While this is true as do not want to miss any potentially lethal arrhythmia, it is also important to understand the differential for wide complex tachycardias so that we can tailor our potential treatments to the specific arrhythmia. It is also important to note that in any unstable patient with a wide complex tachycardia (or narrow complex tachycardia) that electricity is always safe.

Narrow Complex Tachycardias

Intro

The differential for narrow complex tachycardia is extremely important as it is the most commonly seen abnormal EKG in the emergency department. It includes rhythms such as sinus tachycardia, AVnRT, AVRT, atrial flutter, ectopic atrial tachycardia (EAT), atrial fibrillation, atrial flutter, and multifocal atrial tachycardia (MAT).

The goal of this blog is to run through this differential and give some methods to differentiate the rhythms. Although we will not delve too deep into antiarrhythmics, it is important to note that electricity is safe in all unstable rhythms no matter the etiology.