Trick of the Trade: Large volume paracentesis technique using gravity
Recall the last time you were sitting in a room doing a large-volume, therapeutic paracentesis in the ED. Were you stressing out because your other patients were still being actively managed? Large-volume paracentesis is a common and important part of our practice, but often requires your dedicated time at the bedside. Additionally, what do you do if you do not have the fancy paracentesis kit or vacuum collection bottles? [+]
60-Second Soapbox: Abernethy (Pain Medications), Bellew (Posttest Probability), Bouthillet (Wide Complex Tachycardia)
Welcome to the second bolus of 60-Second Soapbox! Each episode, one lucky individual gets exactly 1 whole 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! [+]
AIR Series: Cardiology Module, Part 1 (2015)
There is a phenomenal amount of cardiology content in the FOAMsphere. Accordingly, the CORD testing schedule and our cardiology module has been divided into two parts – Part 1 (ACS) and Part 2 (CHF, Vascular Dissection, and Other). Below we have listed our selection of the 14 highest quality blog posts within the past 12 months (as of July 2015) related to acute coronary syndromes, curated and approved for residency training by the AIR Series Board. In this module we have 6 AIRs and 8 Honorable Mentions. We strive for comprehensiveness by selecting from a broad spectrum of blogs from the top 50 listing [+]
Diagnose on Sight: Recurrent Rash
Case: A 22 year old female presents with a rash on her left arm for several days. She states she has previously had the exact same rash in the exact same location intermittently over the past 2 years. She has no systemic symptoms and has started no new prescription medications, though she has been taking ibuprofen. What is the diagnosis? [+]
PEM Pearls: Migraine Treatment for Pediatric EM Patients
You are working your evening shift at the pediatrics emergency department, and you walk into a darkened patient room with a distressed mother and her otherwise healthy 10-year old son who is curled in a ball, holding his head and crying. Her mother tells you that the around-the-clock ibuprofen has barely touched his 2-day headache. After determining that your patient has no neurologic deficits and that this is most likely a primary headache, what can you do to break his symptoms? [+]
Trick of the Trade: Ear foreign body removal with modified suction setup
A 5 year old boy comes in who has stuck a small unpopped popcorn kernel into each ear. My resident and I discuss different methods to try to get it out including an ear curette, tissue glue, suction, and calling the ear-nose-throat (ENT) specialist. The ear curette won’t work to get around and the kernels are smooth and hard to grasp and might cause trauma with swelling or bleeding. We quickly excluded irrigation because the kernel might swell more. Another method considered was a drop of tissue adhesive onto a q-tip stick to adhere onto the foreign body (FB) for extraction. We were a little leary [+]
Ultrasound For The Win! Case – 76M with Right-Sided Vision Loss #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 bedside ultrasound changed the management or aided in the diagnosis. In this case, a 76-year-old man presents with sudden-onset right-sided vision loss. [+]
Utility of Pre-4-Hour Acetaminophen Levels in Acute Overdose
Case Presentation: A 37 y/o woman presents to the ED with altered mental status. The vital signs are within normal limits. The history is provided by a friend who states that the patient was normal 2 hours ago when they were together. When she returned home, she found the patient in this state next to an empty bottle of acetaminophen (APAP) and 5 empty beer cans. A recent loss in the family has led to some depression in the last few weeks. A battery of labs are sent off including a ‘tox panel’ consisting of serum EtOH, salicylate, and APAP levels. The presumed time of [+]
PV Card: Palliative Care Screening in the Emergency Department
What is Palliative Care? It is specialized medical care focusing on improving the care and quality of life for patients with advanced illness by decreasing suffering. It can be delivered concurrently with curative care. Early identification of patients who are likely to benefit is key. How do you decide whether your patient could benefit from a palliative care consult? Hot off the presses We just published in Academic Emergency Medicine a validated screening tool to identify ED patients who would benefit from palliative care [PubMed abstract].1 In an effort to accelerate knowledge dissemination, the checklist is reproduced here in PV card form. Be sure [+]
60-Second Soapbox: New podcast series featuring Drs. Lin, Riddell, Shaikh
We are excited to announce our new podcast series, 60-Second Soapbox! Each episode, one lucky individual gets exactly 1 whole 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. Don’t worry if your are microphone-shy. We will 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! [+]
Director of Growth, Strategic Alliance Initiative, Center for Innovation and Digital Health
Massachusetts General Hospital;
Chief Scientific Officer, Conductscience.com
Latest posts by Shuhan He, MD (see all)
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