Summary of Heat Related Illnesses

2016-10-13T18:16:37-05:00April 30th, 2013|Environmental|

Heat illness or heat-related illness is a spectrum of disorders due to environmental heat exposure. There are two major categories: minor heat illness [heat edema, prickly heat, heat syncope, heat cramps, and heat exhaustion] and major syndromes [heat stroke]. Heat Cramps Involu

Misplaced King Airway

2016-10-13T18:16:37-05:00April 29th, 2013|Airway|

Case of a cardiac arrest patient who was intubated in the field with a King Supraglottic Airway. He arrived in the ED with on going BVM ventilation. A cervical spine x-ray showed the distal tip of the King Airway had accidentally folded in the pharynx.

Air visualized within IJ after penetrating trauma

2016-10-13T18:16:37-05:00April 25th, 2013|Trauma, Ultrasound|

Take a look at this really remarkable ultrasound image, not so much for it immediate clinical utility, but for its rarity. A patient presented with numerous self-inflicted cuts all over the body including bilateral extremities, torso, and neck. Arrived profusely bleeding, and clear

CT Imaging of Lemierre’s Syndrome

2016-10-13T18:16:37-05:00April 22nd, 2013|Radiology|

26-year-old woman cigarette smoker otherwise healthy. Presented with one week of neck swelling. Little pain. History of frequent pharyngitis with last episode about 1 week ago. Treated with course of azithromycin.

Headaches in the ED

2016-10-13T18:16:37-05:00April 22nd, 2013|Neurology|

There is very little known about the difference between the various types of headaches. In the ED the primary concern is to separate primary from secondary causes of headache. Primary headaches are those that are not caused by a secondary medical condition, and are usually divided

Rapid Sequence Intubation Checklist

2016-10-13T18:16:37-05:00April 18th, 2013|Airway, Safety|

HCMC has created a rapid sequence intubation (RSI) checklist, and printed it in large poster format. It is hung above our airway cart in the stabilization bay. This is organized around the 'P's. There are more detailed considerations under each heading to the right as well. This checklist is designed to be a quick visual reference during RSI to remind you to plan, position, pre-oxygenate (and provide apneic oxygenation with nasal cannula), and be deliberate with your preparation and decision-making. Most importantly, it includes post-intubation steps, that can often be overlooked as the team moves on to other resuscitation steps after securing the airway.

ED personnel at the scene of a disaster

2016-10-13T18:16:37-05:00April 12th, 2013|Disaster|

You are sitting watching re-runs of ‘Jeopardy’ and having a beer when breaking news shows a building collapse that has occurred several blocks from your home. Though you think you know the answer to the puzzle, you are torn between solving it before the contestant does and rushing to the scene. What should you do?

Emergency Department Medication Utilization and Cost

2016-10-13T18:16:37-05:00April 3rd, 2013|Pharmacology|

I practice at Hennepin County Medical Center, a large inner city academic Level 1 Trauma Center. Like all such facilities we have been under a tremendous pressure to reduce costs, and pharmaceutical costs have been a large target. To make us physicians more aware of our prescribing

Alternative Therapies for Primary Headache

2016-10-13T18:16:37-05:00April 2nd, 2013|Neurology|

As droperidol goes back on shortage, I wanted to give a brief review of primary headache treatments. Most therapies for primary headaches have a ~60% rate of pain relief, and there is no predictable overlap between drug classes, so if one class doesn’t work, try another class

Mass Casualty Triage

2016-10-13T18:16:39-05:00April 1st, 2013|Disaster|

There is a historic collapse at the sports complex three blocks from your facility (structural, this time, not the on the field). Hundreds of people are rushing to your hospital for care. What can you say generally about the first arriving victims and what can you do about them? Us