April 06, 2020

Diagnostics: Flex your D Dimer

April 06, 2020/ Ryan LaFollette, MD

In times of COVID, a Dimer of 3000 is nothing to look twice about, however there was an earlier (and future) time where the D Dimer is the hallmark of pulmonary embolism risk stratification. Dr. Comiskey breaks how how this once dichotomous tool has recent data to increase its specificity in elderly patients, pregnant patients and those with low pretest risk factors. Take a look, and when this whole pandemic is over your quiver will be fuller of Dimer tips.

January 27, 2020

Diagnostics: Brain MRI

January 27, 2020/ Ryan LaFollette, MD

If you have ever nodded along as someone described an MRI series weighting, you are not alone. As this modality becomes more accessible to the Emergency Physician, it is incumbent on us to familiarize ourselves with the critical aspects and critical diagnoses of MRI and how to speak the language. Dr. Zalesky takes us on a tour of the physics, indications and low-down of MRI from the ED.

November 11, 2019

Diagnostics: Musculoskeletal Ultrasound

November 11, 2019/ Ryan LaFollette, MD

Ultrasound continues to push into more and more of the physical exam, and nowhere is that clearer than in the musculoskeletal exam. From diagnosing and prognosticating patellar tendon ruptures and ligamentous injuries to being a procedural adjunct in shoulder dislocation to critical identification of necrotizing fasciitis, it continues to push boundaries. Dr. Broadstock gives us a look at some of the applications you need to make yourself a better practitioner in this week’s Diagnostics of Musculoskeletal US post.

September 30, 2019

Diagnostics: Knee and Ankle X-rays

September 30, 2019/ Ryan LaFollette, MD

Hip and knee pain almost categorically get an X-Ray in the ED, but when do you need more? And when could another view help you avoid a more costly imaging test? This week join Dr. Gressick as she gets back to the basics in the acquisition and interpretation of the hip and knee X-Rays

September 01, 2019

Diagnostics: The HINTS Exam

September 01, 2019/ Ryan LaFollette, MD

Dizziness is common and is commonly a frustrating diagnostic dilemma in the ED. As patient’s stories vary between providers, it would be nice if we had a tool that was objective, reproducible and definitive. Enter - the HINTS exam. Join Dr. Ijaz as he discusses this nuanced exam that can change dizziness into a definitive diagnosis.

August 27, 2019

Heat Illness - 2019 Guidelines with Dr. Mel Otten

August 27, 2019/ Ryan LaFollette, MD

Summer is here, hot, and only getting hotter. Join Dr. Mel Otten, former President and Co-Author on the 2019 Wilderness Medicine Society Guidelines for the diagnosis and care of heat related illness.

August 12, 2019

Diagnostics: Toxic Alcohols

August 12, 2019/ Ryan LaFollette, MD

Anion Gap in you obtunded ingestion patient? Weekend gone dry and friends digging through the back of the cabinet? Join Dr. Kimmel as she discusses the diagnostics and therapeutics in toxic alcohol injections and when in doubt, bookmark this for a quick review of their toxicities and metabolites.

June 24, 2019

Diagnostics: Platelet Function Tests

June 24, 2019/ Ryan LaFollette, MD

Platelet transfusion is a hotly debated topic and practice pattern variation is high, which is a great time to get back to the basics. Dr. Urbanowicz gets back to the basics of platelet function assays and the conflicted role of transfusion if they are deemed dysfunctional

June 03, 2019

Diagnostics: MI in Left Bundle Branch Block

June 03, 2019/ Ryan LaFollette, MD

Is the patient in front of you with chest pain and a left bundle branch block an MI? Often the clinical presentation will dictate level of concern, but what about equivocal cases? Join Dr. Walsh as he reviews the diagnostic criteria for MI including Sgarbossa, modified Sgarbossa and a unifying algorithm.

April 22, 2019

Diagnostics: C-Spine Rules

April 22, 2019/ Ryan LaFollette, MD

Clearance of cervical spine is more within the house of Emergency Medicine than anywhere else, so it implores that when we clear a cervical spine using our rules, we take a second to consider the sensitivity, specificity and even more importantly the exclusions that were used in the derivation and validations in these studies. Dr. Gawron takes a look through these rules for our review

April 17, 2019

A Case of the Swollen Leg - III Recap

April 17, 2019/ Ryan LaFollette, MD

Not every swollen leg was made equal, nor should they all be treated the same. In the second installment of our case series, join us on the discussion of a rare vascular complication of the lower extremities.

April 05, 2019

Diagnostics: TEG, you're it

April 05, 2019/ Ryan LaFollette, MD

Thromboelastography (TEG) may be less ordered than traditional coagulation studies, however gives much more specific and detailed information to your patient’s coagulopathy. Join Dr. Wolochatiuk as she explores the indications and interpretations of the TEG.

March 25, 2019

Diagnostics: Alternative EKG Leads

March 25, 2019/ Ryan LaFollette, MD

Ever have a patient that looks more concerning than their EKG? Perhaps their ischemia is in that anatomically difficult to access right ventricle or even posterior. Join Dr. Connelly in looking at the utility of right sided, posterior and Lewis leads and bring something new to your next chest pain patient.

December 31, 2018

Massive Transfusion Triggers: Back to the ABCs (score)

December 31, 2018/ Ryan LaFollette, MD

Massive Transfusion (MT) is a life-saving trigger in trauma centers, but heavy is the burden of activating significant resources without knowing the blood products will go to good use. The ABC is the ACS recommendation, is easy and requires no additional testing, however newer weighted scores like PWH and TASH have showed promise in external validations. This week, Dr. Laurence takes a deep dive into the literature behind these triggers, their validation as well as some take aways for your use of life-saving Massive Transfusion.

December 03, 2018

Diagnostic Questions of the HEART

December 03, 2018/ Ryan LaFollette, MD

Chest pain is a part of our everyday practice, as has become utilization of the HEART score. Successfully weathering a storm of validation, it is incumbent upon us to know the data and variability to its use in the ED. This week Dr. Hunt will take us through the diagnostic view on the HEART score and the data behind it.

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