Monthly Archives: November 2011

Physical and Chemical Restraints in the ED EMCRIT # 60

Post by Swathi Nadindla MD Emcrit Podcast #60: On Human Bondage and the Art of Chemical Takedown The agitated patient can be a danger to himself and even to the staff in your Emergency Department. Here are some pointers on … Continue reading

Posted in 1Advanced, 1Intermediate, EM basics, EMCRIT, Procedures | 3 Comments

How to Think Like an Emergency Physician

Post by Mike Guthrie, MD Here’s the link! Standard system for seeing patients, i.e., what is taught in medical school = Bottom up approach: Hx →PE→ Ddx→ ancillary testing→ treatment. Goal of standard system is to figure out a patient’s … Continue reading

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Survey

Before you begin your journey with media.sinaiem.org; if you haven’t completed the medical education survey, please do it now!   It shouldn’t take you more than 5 minutes, and you will be helping me out.

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SMART EM – Pulmonary Embolism

 By Dena Asaad-Reiter, MD Pulmonary embolism (PE) is much more prevalent than one would expect. Various autopsy studies done in the 1960s-1970s demonstrated up to a 70% incidental finding of PE. Old literature tells us that the mortality of missed … Continue reading

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SMART EM Placebo Paradox

By Kei Ko, MD Placebo Paradox Despite its negative connotations, the placebo effect is real. Multiple studies and examples of placebo effect and meaningful effect placebo is able to elicit –          Mosely, et al., in NEJM 2002, study of knee … Continue reading

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SMART EM – Chest Pain

  By Kei Ko, MD In this episode of SMARTEM, we dive into the risk associated with chest pain, focusing on MI and death. Cardiac cath is not included as an endpoint as it is technically not a patient oriented … Continue reading

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Manny Rivers III

The Saga is complete!   Is there a role for protein C? Protein C is usually decreased in sepsis resulting in multivascular thrombosis. However, Cochrane study do not support this and may lead to more bleeding…River’s disagrees and gives it … Continue reading

Posted in 1Advanced, 1Intermediate, Critical Care, EMCRIT, Resuscitation, Sepsis | 1 Comment

Hypertensive Emergencies SW style

Hypertensive Emergencies SW style  Rule out #1 & # 2, so you can focus on #3… (email me if you don’t know the sinaiem UN/Pw) 1)Hypertensive Urgency 2)Markedly elevated BPs 3)Hypertensive Emergency 1) Hypertensive urgency: Patients with high BPs but … Continue reading

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Non-Invasive Ventilation can be sexy too…

Post by Vishal Demla Listen to the EMCRIT Podcast #19 and read the summaries; could save your life. PEEP= CPAP Type 1 failure: Not oxygenating NEED PEEP/CPAP/EPAP Recruits aveoli, decrease V/Q mismatch, decrease preload/afterload Start at 5 up to 15 APE, … Continue reading

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Manny Rivers on EMCRIT Part 2

Post by Vishal Demla The discussion on severe sepsis continues with Manny Rivers on EMCRIT 55 1) How much fluid do you give in EGDT? When the  patient goes from fluid responsive to unresponsive Optimizing CVP does have correlation with … Continue reading

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