Ludwig’s Angina is an uncommon but dangerous floor of the mouth infection. It is important to recognize and manage it appropriately. For this reason we present images and video of a case of Ludwig’s Angina… and sprinkle in nuggets of wisdom regarding source, presentation, complications, and management.
Read MoreIn this post and podcast we review mRNA vaccines and the Pfizer phase 3 study to help frontline providers answer some important questions- What is an mRNA vaccine? How does this differ from the traditional vaccines? Is it safe? Efficacious? We take a closer look at the recent NEJM article to help us come to a final answer on the most important question- Should I feel comfortable getting this vaccine?
Read MoreVasopressors are used in Emergency Medicine to treat cardiac arrest, hypotension, and shock. Recent studies have sought to investigate questions around timing, medication choices, and administration of these medications in varying clinical scenarios. The emergency provider must be familiar with the properties of, and indications for, vasopressors in the ED setting. In this journal club summary, we review the evidence on the impact vasopressors have on clinical outcomes.
Read MoreIntubation in the emergency department (ED) can be a stressful endeavor. We are often presented with patients who have complex anatomy and tenuous physiology. Because of this, it can be hard to look past the critical step of securing the airway. Rapid sequence intubation (RSI) and positive pressure ventilation can dismantle patients’ physiology and contribute to an almost 4% rate of post intubation cardiac arrest (PICA). Is there anything we can do to predict or prevent this? In this podcast, Sam Wood gives us an overview of the literature to help us answer these questions.
Read MoreDespite the widespread prevalence of concussions, little is known about its ideal management. The traditional recommendation for concussion treatment has centered around the concept of “brain rest” in addition to physical rest. There is little medical evidence to support this recommendation. Our journal club sought to answer whether some physical activity could actually benefit patients with acute concussion and additionally reviewed a study (completed in Maine) that challenged the belief concussions have long term cognitive effects. Read on to see what you think!
Read MoreThe management of diabetic ketoacidosis (DKA) in children is full of difficult questions- how much insulin should I give? Who is at risk for cerebral edema? What treatments, if any, increase the risk for this dreaded complication? Which fluid is ideal? How much of this fluid should I give? We sat down with ED physician and endocrine aficionado Dr. George Willis to answer these questions.
Read MoreWe are extremely fortunate to have one of our fearless ultrasound leaders, Dr. Andrew Fried, lead us into the world of resuscitative transesophageal echocardiography at Maine Medical Center. In our recent grand rounds, he presented the latest cutting edge literature behind this technology and why its the right thing to do for our patients.
Read MoreCOVID19 has presented many difficult challenges in its diagnosis and managment. This is no truer than bedside lung evaluation. Personal protective equipment can be prohibitive of adequate lung ausculation and the use of a stethoscope is discouraged by some as it is considered a high risk fomite. Fortunately, point of care ultrasound (POCUS) continues to be an important tool in the emergency provider’s toolbox for decision support and risk stratification. It is quick to perform, easy to interpret, and may be done quickly at the bedside. To help us quickly understand the technique, findings and evidence behind lung POCUS for the COVID19 (+) or suspected patient, ultrasound fellow Dr. Christopher Allison has crafted us a high yield infographic.
Read MoreUterine bleeding is a common presentation to the Emergency Department and rarely these patients are SICK. When they come in sick, it's not the time to be googling the ACOG recs on managing uterine bleeding. Here we review the proper management of the pregnant, post-partum, and non-pregnant patient with uterine bleeding.
Read MoreThe personal protective equipment (PPE) for COVID-19 has been the center of attention in the medical world and laypress, in part because of the short supply and in part because of the importance of healthcare personnel safety. In this vodcast we review the different levels of PPE and what you need to know to safely protect yourself.
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