Recently the Emergency Medicine docs at TamingtheSRU.com and University of Cincinnati Emergency Medicine Residency Program have been sharing some innovate first person videos focused on procedures in the ED. Here is an example of pericardiocentesis. You may be familiar with the diminutive Go Pro (GoPro.com) as the camera of choice for extreme sports enthusiasts, but it has several [...]
You are seeing a child who is well appearing but has a dramatic rash. The rash appeared this morning and seemed to begin on her torso, later spreading to her limbs. The daycare thought that it was an allergy and was going to give her another child's EpiPen, despite no respiratory symptoms and no history of previous allergy in the [...]
Check out the first in the PEMBlog Shorts Video series.
Spoiler alert... There is currently a shortage of intravenous fluids in the US. This knowledge may come in handy if your ED is beset by dehydrated St. Patrick's Day revelers. Specifically supplies are constrained for both normal saline and lactated ringers, plus 5% dextrose solutions. I shouldn't have to tell you that this is potentially a very big deal. There [...]
You may have noticed that many editions of PEM Currents align themselves closely with posts on the blog. This is by design! I want to make sure that I share the content in as many formats as possible in order to reach the widest audience. It goes without saying that recognizing osteomyelitis can be challenging. Treating it doesn’t have to be [...]
Here are the links for the entire five-part series on osteomyelitis. PART 01 / ETIOLOGY PART 02 / HISTORY + PHYSICAL EXAM PART 03 / LABS PART 04 / IMAGING PART 05 / TREATMENT
Let's move onto the final part in the osteo series - treatment. Editors note: small corrections were made on 3-14-14 with the addition of information of ortho consultation and the delay of antibiotics and changing cephalexin to cefazolin. Thanks to Dr. Indi Trehan for alerting me to the errata. Choosing the right antibiotic If you think its osteo, then start [...]
By now you've likely seen parts one, two and three. Moving in a logical direction part four will focus on imaging, As you'd imagine, radiographic studies are supremely important in the diagnosis of osteo. Let's take a look by modality shall we? Plain films The bottom line is that it can take up to 2-3 weeks for the typical osteo [...]
If you've been following along with parts 1 and 2, then part 3 is the next logical step- because, um, counting? Let's look at laboratory studies in osteo. It may come as no surprise that the initial labs that end up being most helpful are CRP, ESR and blood culture. Pääkkönen et al noted that both ESR and CRP were highly sensitive at [...]
Welcome back to the Osteo series - Whereas part one focused mainly on etiology, part 2 delves into making the diagnosis with a good history and physical. I should really say that your history and physical helps increase your index of suspicion - since osteo can be quite elusive especially in the early stages. Harkening back to part one, it [...]
