I can't think of a recent shift in which I haven't placed a patient on oxygen. Given that, I wanted to share a brief teaching video on some of the various modalities for oxygen therapy in use in the Pediatric Emergency Department. Enjoy! http://vimeo.com/101403657
There are some things that we seem to do reflexively in the ED. Giving steroids to a patient with an asthma exacerbation is one of those things. Ask yourself the following question. Why do we do this? What is the evidence behind it? Can you cite any of the studies that lead to this common practice? I couldn’t fully elaborate [...]
The Differential Diagnosis for sore throat is quite long, though it is usually infectious. I will approach the approach that you should consider using when you approach the patient with a sore throat. I hope I don't face reproach for the gratuitous approach laden approach. Does the patient have respiratory distress? If the answer is yes to this one stop everything [...]
I know that performing an accurate and efficient joint exam in the ED can be challenging. Reviewing an ideal example in a "just in time" fashion can be a wonderful way to prepare for an upcoming patient. With that in mind I wanted to direct you to an excellent online resource from the Heart of England Foundation Trust’s Emergency Department. [...]
The case(s) You are seeing a pair of siblings that crashed into each other while jousting on their bikes. They were wearing helmets but both sustained forearm injuries. Both have swollen, tender forearms and you get X-Rays. And, no, there is not a BOGO discount. The Diagnosis Both patients have forearm fractures. Patient A has a buckle, or torus fracture. This [...]
There are many demands in the emergency department, some of which come from patients and their families. This post in the Art of Medicine series looks at those situations in which patients/parents are wondering whether or not you are qualified to be caring for their child. As I noted in the last post in this series the ED is a stressful environment. Parents are legitimately, and rightfully [...]
Umbilical granulomas are often an incidental finding on physical exam, but can be the reason a patient presents to the ED. These fleshy pink masses represent incomplete epithelialization of tissue that persists after the cord separates. It has the honor of being the #1 belly button mass in newborns. On exam they are soft, wet and pink and can be [...]
There are multiple topical anesthetics that we use in the ED. The common theme is that all of these drugs with -caine cause sodium channel inhibition in nerves, which blocks axonal transmission leading to the typical numbness and and localized weakness. I admit that it can be a bit confusing as to which one you should use and when. The aim [...]
Since we talked about rabies this morning I wanted to share a very affecting podcast that the awesome folks at Radiolab put out recently. Take a listen: You can see more at Radiolab.org and check out the podcast itself with additional links here.
Check out this video that I made that reviews basic splinting technique. This can be applied to any number of splints.
