Many clinical decision rules exclude elderly patients from the derivation cohorts. So the question remains unanswered do all elderly patients need cervical spine CTs in the setting of trauma? What if they have no symptoms? This recap of a journal club article explores the incidence of significant cervical spine fractures in elderly patients.

It is well known that ultrasound has exploded in its application in both diagnostics and procedures and has ultimately revolutionized the way we practice medicine. With its growing use, more and more providers are comfortable using ultrasound for both identification of anatomy/pathology and to guide procedures that were previously only done with landmarks. While having the skills to perform landmark guided procedures is incredibly important, there is much value in being able to visually confirm anatomy to avoid procedure complications, especially when landmarks are difficult to palpate / identify in certain individuals. This recap of a recent journal club article covers a paper looking into the use of POCUS to help perform cricothyrotomy.

More than 1.5 million critically ill adults undergo tracheal intubation each year in the United States. Hypoxemia is a common and serious complication during tracheal intubation in critically ill adults, occurring up to 10-20% of intubations in the emergency department (ED) or intensive care unit (ICU). Hypoxemia increases the risk of cardiac arrest and death. The effect of preoxygenation with noninvasive ventilation, as compared with preoxygenation with an oxygen mask, on the incidence of hypoxemia during tracheal intubation is uncertain. In this breakdown of a Journal Club article, Dr de Castro will cover a recent paper comparing NIPPV to oxygen mask only during preoxygenation for intubation.

Join Dr Haupt as she discusses the adrenal glands, their role in hormone production and other functions throughout the body, and common problems that can occur when the adrenal glands are not working properly. Although most of these issues are non emergent problems, occasionally they will be seen in some sort of acute adrenal crisis in the emergency department and ER physicians should be well versed in their often subtle presentations!

We know that the d-dimer can be a helpful test for patients who have a low pre-test probability of pulmonary embolism. But can the test be pushed into use for higher risk patients? Will it still have useful negative predictive value or will we risk missing too many PEs?