Little Patients, Big Medicine Podcast: Lactate in Pediatric Sepsis

The first recording from Little Patients, Big Medicine: the Pediatric Emergency Medicine (PEM) Podcast. This is an exciting interview with Dr. Halden Scott, a PEM physician at Children’s Hospital Colorado, about the use of lactate measurement in pediatric sepsis. Dr. Scott is one of the premier pediatric sepsis researchers, with a specific focus on the use of lactate measurement in the ED. We talk about the Sepsis-3 definitions and whether pediatrics will eventually follow them, Dr. Scott’s previous work on lactate use in the pediatric ED, and her new article published in March of 2017 on the association between elevated lactate in the ED and 30-day mortality in children. ^1–6
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By Jason Woods, MD|2017-06-30T05:59:23-07:00Jun 7, 2017|Infectious Disease, Pediatrics|

Trick: Linear Ultrasound Transducers in Intrauterine Pregnancy Evaluation

The volume of women presenting to the emergency department (ED) with newly diagnosed first-trimester pregnancies and suspected ectopic pregnancies sometimes seems like an infinitely growing number. As ED physicians, proper identification of an intrauterine pregnancy (IUP) in these patients is of paramount importance and the initial imaging test of choice for many has become bedside point-of-care ultrasound (POCUS).

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By Amy Phillips, MD|2019-11-10T21:32:28-08:00Jun 4, 2017|Ob/Gyn, Tricks of the Trade, Ultrasound|

Beyond the Abstract | Shared Decision-Making in the ED: 3 Factors That Matter

Shared decision-making seems to be more popular than Snapchat these days. Everyone in emergency medicine is talking about it… but who is actually doing it properly? In our recent concepts piece published in Annals of Emergency Medicine, we describe 3 key factors that must be present for shared decision-making (SDM) to be appropriate in the emergency department (ED).

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By Marc Probst, MD|2019-04-18T15:03:19-07:00May 31, 2017|Beyond the Abstract|

Traumatic Bleeding in Anticoagulated Patients: 5 Other Sources Beyond the Brain

When a patient is started on anticoagulant therapy, the purpose is to prevent clot formation or propagation. Anticoagulants can improve morbidity and mortality by maintaining cardiac stent patency, reducing the propagation of pulmonary emboli, or preventing formation of intra-cardiac thrombi.^1,2 Unfortunately even after minor trauma, these medications can cause major problems. When a patient on clopidogrel is in a motor vehicle collision (MVC) or an elderly patient on warfarin falls out of their bed, the once life-improving therapy becomes potentially life-threatening. It is important for emergency care providers to maintain a high index of suspicion for life-threatening bleeds in all patients on anticoagulation following even minor injuries. The purpose of this discussion is to look beyond the intracranial hemorrhages (ICH) and to consider 5 other sources of bleeding that can occur in anticoagulated patients.

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By Jillian Bores, MD|2017-06-04T15:51:12-07:00May 29, 2017|Heme-Oncology, Trauma|

60 Second Soapbox: Shared Decision Making, Backboards, and Caring for the Family

Its’ time for another installment of 60 Second Soapbox! Each episode, one lucky individual gets exactly 1 minute to present their rant-of-choice to the world. Any topic is on the table – clinical, academic, economic, or whatever else may interest an EM-centric audience. We carefully remix your audio to add an extra splash of drama and excitement. Even more exciting, participants get to challenge 3 of their peers to stand on a soapbox of their own!

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By Sam Shaikh, DO|2019-02-19T18:47:28-08:00May 22, 2017|60-Second Soapbox|

Ultrasound For The Win! – 20F with First Trimester Vaginal Bleeding #US4TW

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this case series, we focus on a real clinical case where point-of-care ultrasound changed the management of a patient’s care or aided in the diagnosis. In this case, a 20-year-old woman presents with first-trimester vaginal bleeding.

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By Eunice Choi, DO|2019-11-10T23:20:22-08:00May 15, 2017|Ob/Gyn, Ultrasound, Ultrasound for the Win|

PEM Pearls: Search & Rescue of Ear Foreign Bodies – Picking the Right Tool

While ear foreign bodies can happen at any age, the majority occur in children less than 7 years of age.¹ The younger the patient, the less likely they are cooperative with the exam and, therefore, the less chance of successful foreign body removal. The first attempt at removal is the best, so it is important to make it count. Similarly, different types of foreign bodies call for different “tools” for removal. It is important to understand when to attempt removal in the emergency department (ED) and what tools are available. This blog post will help you optimize your first pass success at foreign body removal by understanding what tools are at your disposal.

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By Josh Bukowski, MD|2017-10-26T14:32:51-07:00May 8, 2017|ENT, Pediatrics, PEM Pearls|

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