Category Archives: 1Advanced

Ultrasound Podcast with Mike and Matt on Small Bowel Obstruction

By Elizabeth Dei Rossi, MD Please refer to The Ultrasound Podcast Different modalities can be used for diagnosing SBO CT scan is considered gold standard sensitivity of 92% and a specificity of 93% Mallo RD et al. CT diagnosis of … Continue reading

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Severe Accidental Hypothermia

By Taylor Moran-Gates, MD Please refer to EMCrit 1. >32c: -Treatment is simple: Passive rewarming, warm blankets. -Evaluate other causes: hypoglycemia, etoh, myxedema, Addison’s, sepsis. -Labs: cbc, chemistry, tfts, cortisol, cultures. -Bradycardia: sinus bradycardia is expected, and does not require … Continue reading

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Erasing Death

By Sabrina Schmitz, MD “Erasing Death” Explores the Science of Resuscitation (NPR—Feb 20, 2013) SUMMARY:   This is an NPR interview of Dr. Sam Parnia, Director of Resuscitation Medicine at Stony Brook, in which he discusses ideas presented in his … Continue reading

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Ventilator Management

By Jake Isserman, MD Please refer to EMRAP An asthmatic patient had failed NIV and been intubated.  The vent alarm was continuously sounding—for high peak pressure. He was sating 100%.   The team had been adjusting the settings and had … Continue reading

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Posterior MI: The Dark Side of the Moon

Goreselen et al. Neth Heart J. 2007 January; 15(1): 16–21. By Vincent Roddy, MD Background: True posterior MI is difficult to recognize bc the leads of the standard EKG are not a direct representation of the area involved.   Only with indirect changes … Continue reading

Posted in 1Advanced, Cardiology, Chest pain, EKG | Leave a comment

Treatment of Aortic Dissection

By Paolo Hernandez, MD Please refer to EMCrit Most import thing is to lower dP/Dt, change in pressure seen by aorta over time, by decreasing heart rate, ionotropy and afterload.  This can be done by: -        Step 1:  Control pain!!! … Continue reading

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Increased ICP and Herniation

By Tatiana Havryliuk, MD Please refer to EMCrit Ocular nerve sheath ultrasound – tegaderm, linear probe, 3mm down, then measure across – width  of optic nerve sheath is directly proportional to ICP – if <5mm then no ICP, if >6mm … Continue reading

Posted in 1Advanced, Critical Care, EMCRIT, neuro | Leave a comment

The Crashing Neonate

By Christie Lech, MD Refer to EMRAP Unbundle babies. Get a good blood pressure. Neonates will not present with meningismus with meningitis Get a line! Think IO. Or a scalp vein. Get the neonates weight. Hct are high when babies … Continue reading

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SMART SAH: A Picture is Worth a Thousand LPs

By Will Fleischman, MD Please refer to SMARTEM Overview: Headaches and SAH: Headache is chief complaint for 3% of ED visits 3-4% with grossly normal neuro exam will have serious pathology roughly 1% SAH according to Perry et al, CJEM … Continue reading

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Matt and Mike’s Podcast on Hip Ultrasound

By Felipe Teran, MD Please refer to Ultrasound Podcast  In this episode Matt and Mike discuss the utility of US for: -       Diagnosis of hip effusion -       US guided hip aspiration -       US guided hip injection US guided hip aspiration … Continue reading

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