Contributor: Don Stader, MD Educational Pearls: Fractures and dislocations that require reduction do not necessarily require sedation Nerve blocks are an effective alternative that can provide analgesia to reduce fractures and dislocations and provide sustained pain relief after the reduction is completed Hematoma blocks are effective for distal radius and various ankle fractures Shoulder dislocations…
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Calcium burns Chief Complaint: Calcium Burns HPI: 46 year old male with past medical history of ESRD on HD, hypertension, congestive heart failure and secondary hyperparathyroidism underwent a subtotal parathyroidectomy without complications 18 days ago. Pt had extravasation of IV calcium chloride infusion to his right forearm 17 days ago; hand surgery was consulted and…
Read MoreContributor: Donald Stader, MD Educational Pearls: Not uncommon for patients presenting after opiate overdose and narcan administration to be observed for 4-6 hours This has been based more on tradition than evidence Observation periods for overdose may vary based on the opiate(s) used Fentanyl and heroin have half lives of about 2 hours, while oxycodone…
Read MoreContributor: Sam Killian, MD Educational Pearls: Droperidol (Inapsine) is an antipsychotic drug with efficacy for nausea, vomiting, headaches, and treating agitation In the early 2000’s, Droperidol received a black box warning for QT prolongation This caused a precipitous drop of in administration and ultimately led to a stop in production More careful analysis since has…
Read MoreEmergency Medical Minute collaborated with CarePoint Health in early March for a night of education on Pediatric Emergencies geared towards mid-level providers at a local Denver brewery for our latest Brewcast. Pediatric patients require special considerations compared to adults when receiving medical care, and that remains true when dealing with fevers across different age ranges….
Read MoreContributor: Aaron Lessen, MD Educational Pearls: True allergies to penicillin compared to reported allergies from patients ranges around 10% Recent study took patients undergoing sensitivity tests and developed the PEN(icillin)-FAST score to address reported penicillin allergies PEN-FAST has four components for a total score of 0-4: o F = five years or less since…
Read MoreContributor: Don Stader, MD Educational Pearls: Local anesthetics injected directly into wounds can cause distortion – especially important in facial lacerations Several blocks can be helpful to help numb branches of the trigeminal nerve (CN V) which innervates the face: Supraorbital nerve block: blocks distribution of V1 (most of the forehead) through injection above the…
Read MoreGeneral Counsel attorney, Debi Smith, joins Dr. Nick Tsipis to discuss the ins and outs of healthcare law. Many people forget that a subpoena only compels attendance to a court date, it does not compel one to provide any information on a case without a specific HIPAA compliant authorization for use and disclosure of protected…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: Early antibiotics have been shown to improve outcomes in septic patients time after time Emerging evidence challenges the concept of one-size-fits-all large fluid boluses for septic shock patients and fluid may worsen patients who have underlying sepsis-induced pulmonary capillary leak Starting peripheral vasopressors early, and relaxing if fluid resuscitation…
Read MoreContributor: Sam Killian, MD Educational Pearls: One study found that patients presented with headaches more frequently when there was high temperatures and low humidity, while higher humidity is correlated to lower incidence of headache. Moon phases had no effect on headache frequency. A Canadian study looking at over 100,000 ED visits for headaches found…
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