September 2013 Update: Expert Peer Reviewed posts
It’s been a month since we started adding expert peer reviews to our blog posts, and we have had a flurry of engaging conversation surrounding the new process. During this time we have worked to develop a sustainable peer review process. In fact there are two ongoing expert peer-review processes:
- Clinical articles: There have been 10 clinical articles thus far expert peer reviewed on a post-publication basis. See list below.
- MEdIC series: Dr. Teresa Chan and Dr. Brent Thoma host this monthly series on challenging educational cases with initial posited questions, followed by a summary review which includes expert input (added on a pre-publication basis) one week later.

Derangements in acid-base status are commonly discovered on routine emergency department evaluation and often suggest the presence of severe underlying disease. Many acute conditions can disrupt homeostatic mechanisms used to buffer and excrete acid, and these changes may necessitate immediate intervention. When you discover a patient with an abnormal pH, what is your approach to the diagnosis?
Rob Bryant, MD (
Recently, I have been asked by several students at my home institution (UTHSC at San Antonio) to help them understand bundle branch blocks. This is different than some of my usual posts because it is meant to be more educational than evidence based. So here we go. The normal conduction system of the healthy heart is shown to the right. If there is a delay or block in the left or right bundle, depolarization will take longer to occur. Therefore we get a widened QRS (>0.12 sec or >3 small boxes).