ACMT Toxicology Visual Pearls: I’ll Huff and I’ll Puff…
The abuse of which common office supply substance can result in syncope and the EKG findings shown? Dust Off (difluoroethane) Elmer’s glue (polyvinyl acetate) Hand sanitizer (ethyl alcohol) Rubber cement (heptane, isopropyl alcohol) [+]
Kathryn T. Kopec, DO
Carolinas Medical [+]
Silence is not an option: Addressing structural racism in medical education
The year 2020 has been a year of upheaval. The COVID pandemic revealed disparities in healthcare and its effects on marginalized groups such as the Black community. The pervasive effects of structural racism affect all of us, including in medical education. We cannot and must not remain silent. As we honor Juneteenth, #BlackLivesMatter, and #WhiteCoatsforBlackLives, let us reflect on ways we can address racial injustice in our direct environment. [+]
Hydroxychloroquine Toxicity
As the COVID-19 pandemic continues to unravel, the role of hydroxychloroquine (HCQ) in the treatment of patients with this disease has been a major focus of discussion on the news and social media. Despite the lack of good data supporting its use in the clinical setting, there have been numerous reports of individual consumption of HCQ resulting in accidental overdose and even death. It is therefore important to recognize and manage patients who may present with HCQ toxicity. [+]
Trick of the Trade: Windex for Ring Removal
A 41-year-old male presents with left-hand pain after an altercation. The patient’s hand is noted to be swollen and tender, particularly over the 4th-5th metacarpals, with mild swelling extending to the 4th-5th digits. The patient also notes that he slightly deformed his wedding ring during the fight and he has since been unable to remove it. It’s a busy overnight and the patient has been in the waiting room for an hour. While waiting nursing staff had the patient ice his hand while elevated and attempted to remove the ring with a water-based lubricant. All attempts to remove the ring [+]
How I Stay Healthy in EM: Michael Paddock
Emergency medicine physicians serve on the “frontline” every time we walk into a shift but would be remiss to not acknowledge the unique challenges we have faced over the last few months, both as a specialty and as individual clinicians. Prevention of burnout and active wellness management is more important now than it ever has been. This month on our “How I stay Healthy” series, we’re featuring Dr. Mike Paddock, Staff Physician with the Regions Hospital EM residency program who shares his down-to-earth wisdom regarding what he does to thrive as a physician, educator, advocate, father, and friend. [+]
Trick of the Trade: Angiocatheter for manual aspiration of priapism
A 25-year-old man presents with 6 hours of penile pain and swelling after recreational penile injection of Trimix (alprostadil, papaverine, and phentolamine). He denies any history of sickle cell disease or penile trauma. On exam, he is in moderate discomfort and has a tumescent penis with a soft glans. You suspect the patient is suffering from ischemic, low-flow priapism. Manual compression and ice application have been attempted with no significant improvement in the patient’s clinical status. [+]
ACMT Toxicology Visual Pearls: A Foraging Experience to Die For
What life-threatening symptoms can result from the ingestion of this plant? Delayed onset bone marrow suppression Hepatic failure Mucosal swelling of the anterior airway Paralysis and respiratory failure [+]
Robert Goodnough, MD
Department of Emergency Medicine, Baylor College of Medicine
Latest [+]
EM Match Advice: Program Directors Reflect on the 2020 Residency Match
How competitive was the 2020 EM residency match? Although COVID-19 has changed some of the rules and planning for the 2020-21 residency application season, historical data still remains a helpful guide. We have updated our annual table summarizing how competitive the EM residency match was, based on National Residency Matching Program (NRMP) data. [+]
All-EM Residency Graduation Extravaganza: Save the Date
We invite all of you to join the first-ever all-EM residency graduation event to celebrate the #EMClassof2020 who are embarking on their professional careers in an especially tumultuous time in history. Although this online event cannot replace the experience of an in-person departmental event, we hope that we can all take a collective pause to realize how connected we are in EM and even find some joy in these dark times. As a testament to this momentous “leveling-up” event, world-class speakers, Dr. Esther Choo, Dr. Mel Herbert, and Dr. Amal Mattu will headline a series of well-wishes and inspirational words. [+]
Trick of the Trade: Sodium Bicarbonate for Acute Symptomatic Hyponatremia
A 25-year-old woman is brought into the emergency department by friends due to “acting weird.” She was at a rave and is reported to have consumed alcohol, marijuana, and ecstasy. On exam, she is afebrile, tachycardic, normotensive, and breathing comfortably on room air. She is lethargic, mumbling incomprehensibly, and does not follow commands. Her glucose is 115 mg/dL, her pregnancy test is negative, her EKG reveals sinus tachycardia, her ethanol level is 30 mg/dL, and a stat CT head is negative. Her chemistry panel reveals a sodium level of 114 mEq/L. You order a 100 mL 3% sodium chloride bolus, [+]