An old mentor of mine liked to say "sometimes lungs are better seen than heard." While he was referring then to good old fashioned chest xray, current literature clearly supports the use of bedside ultrasound as a valuable tool in evaulating the dyspneic patient. In this lecture, Dr. Jacob Avila discusses the use of the bedside ultrasound in detecting pneumonia, pulmonary embolism, congestive heart failure, and pneumothorax.
Read MoreWondering which fork in the road to take after your emergency medicine residency? Interested in academics, but would also love to find that sweet job with surf just down the street? We were fortunate to have a parade of stars for our 2017 emergency medicine career day. Take a look to find help on buffing your CV, finding your fellowship, evaluating an academic career, or critiquing a contract for a private group.
Read MoreIt's 3 AM and EMS brings in a patient with altered mental status found down in the local park. His glucose and vital signs are normal and there is no clear etiology on his exam. As part of your work up, you order a CT brain to evaluate for a neurologic case. Unfortunately, teleradiology has been taking up to 90 minutes to give an interpretation on your CT's. As the patient is taken off the scanning table, you quickly peruse his CT and wonder. . . will I be able to identify an emergent diagnosis before my friendly "neighborhood" radiologist?
Read MoreOur very own Irish George Clooney shares some pediatric pearls as he discusses the pros and cons of testing for and treating streptococcal pharyngitis including: using the centor criteria in children, test characteristics of the rapid antigen detection test, risks, complications and potential benefits of treating versus not treating and how to discuss these issues with parents.
Read MoreDizziness accounts for 4-5% of all emergency department (ED) chief complaints and 26% of ED patients endorse dizziness in their review of systems. Although most presentations for dizziness are benign, nearly 200,000 strokes present with dizziness each year in the United States (Edlow et al. 2008). Misdiagnosis of vertebrobasilar strokes is common, as symptoms may be minimal and patients often change how they characterize their symptoms. In the video below, Dr. Siket covers a systematic and evidence based approach to guide your workup of this all too common patient.
Read MoreYou stuck what where?!?! Dr. George "Bud" Higgins shares with us some tricks of the trade regarding evaluating and removing intra-nasal foreign bodies. He discusses some well known maneuvers ("parent's kiss," passing a foley catheter, bayonette forceps) and a more novel approach using intranasal positive pressure gas flow.
Read MoreWhile he may talk funny, Dr. Michael Ferguson is a phenomenal educator who has won our off service teacher of the year award multiple times. This week we share with you his lecture "Updates in Pediatric Sepsis," recorded at the 2017 Maine Medical Center Emergency Medicine Winter symposium.
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Read MoreEmergency physicians regularly see psychiatric patients who are having suicidal thoughts or engage in non-suicidal self-injurious (NSSI) behavior. In addition to working these patients up medically, it is part of our job to determine who needs emergent evaluation by a psychiatric provider and who is safe for discharge. This is a very important decision, as we do not want to send high risk patients home and keep low risk patients for extended periods of time while they await their evaluation. Balancing this can be difficult - oftentimes it is not obvious where a patient falls on this spectrum. We are taught various decision aids in medical school to help us risk stratify these patients - but how do they perform on emergency department patients? For this month's journal club, we looked at three papers that examine three different decision aids to help elucidate this issue.
Read MoreFingernail avulsions constitute a unique fingertip injury as they have the potential to result in long term nail deformity and impaired function if not repaired properly. In order to treat these injuries effectively, the treating provider must understand the anatomy of the nail bed, nail root, and the intricacies of nail growth. In this brief video, Dr. George "Bud" Higgins shares with us how to assess and treat this injury to optimize our patient's chances for successful nail regrowth, function and cosmesis.
Read MoreThe following airway pearls were gleaned from Dr. Mike Winters' lecture "Critical Care Quickies - Pearls for the Moribund Patient." This was presented at the pre-conference workshop "Resuscitation for Emergency Physicians" (23rd Annual Scientific Assembly of the American Academy of Emergency Medicine in Orlando, Fl).
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