This week’s grand rounds features an overview of crush injuries with Dr. Della Porta, a fantastic look into the evidence behind preeclampsia and eclampsia management with Drs. Brower and Jackson, a discussion of evidence behind emergency medicine pharmacology dogma with Dr. Nagle, and a discussion of the cost of healthcare with Dr. Thompson.
Read MoreRenal colic is a common presenting symptom in the ED, with an estimated prevalence as high as 10-15% in the US. (1) It accounts for approximately 1% of all ED visits per year. (27) Most patients will pass these calculi spontaneously and do not require surgical intervention, therefore focus on pain relief is of utmost importance in the emergency department. (1) NSAIDs have shown to be as effective, if not more effective than opioids, making them a reliable first line agent. (4,5) Opioids still provide a viable option in those with kidney disease or gastric ulcer disease, however they may be best utilized as combination agents to decrease the need for rescue analgesia. There is weak evidence to support the use of IV acetaminophen, with high cost burden, limiting its utility. Additional agents such as ketamine, lidocaine and magnesium carry with them limited evidence and inconsistencies in the literature, limiting their use, with further studies required. Alpha blockers seem to provide a shorter duration to expulsion, fewer pain episodes, and less hospital admissions with surgical intervention, specifically with larger stones (>5mm).
Read MoreHow do you treat acute low back pain that comes into the ED. Do you have a ‘cocktail’? Do you have any injections / stretching that you recommend? Is there data behind any of that?? Join Dr. Gillespie on an evidence-based look at the therapeutics of low back pain in the ED.
Read MorePediatric cardiac arrests are, potentially, some of the most challenging patients for an emergency physician to care for. Cognitively, emotionally; these patients push us to our very limits. In this journal club recap, we cover 3 recently published articles looking at the care of these patients. Should survivors be cooled? Is Epi any good? Which is better amiodarone or lidocaine?
Read MoreLast week we had our first Journal Club of the year and had an excellent discussion of the evidence surrounding the use of amiodarone, lidocaine, and procainamide for ventricular dysrhythmias. Take a listen to the podcast below and read up on the details of the papers below that!
Read MoreSRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
