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EM@3AM: Murine Typhus

EMDocs

We’ll keep it short, while you keep that EM brain sharp. 2018 Oct-Dec;55(4):258-264. A 52-year-old male with a history of essential hypertension presents to your South Texas ED for his second visit this week complaining of indolent fever, shortness of breath, pleuritic chest pain, and a rash on his trunk and extremities.

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EM@3AM: Stercoral Colitis

EMDocs

Well keep it short, while you keep that EM brain sharp. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days. If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. Cureus, 15(7), e41705.

EMS 96
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The Broselow-Luten System

Pediatric EM Morsels

James Broselow, a family medicine-turned-emergency medicine physician from Hickory, North Carolina , recognized that his team spent a lot of time trying to calculate doses of medications rather than spending their mental energy on the actual medical decisions for the resuscitation. This system has now become the “ industry standard.”

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Neurogenic Shock in Children

Pediatric EM Morsels

To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. 2018 Oct;14(2):47-54. Epub 2018 Oct 31. Never fear. Alpha 1 agonists are necessary to maintain appropriate blood pressure.

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ECG Blog #427 — To Cath this Elderly Patient?

Ken Grauer, MD

The ECG in Figure-1 — was obtained on the scene by EMS ( E mergency M edical S ervices ). Unfortunately the patient arrested before catheterization could be completed — and could not be resuscitated. The patient was a man in his 90s, who ~1 hour earlier, noted the onset of severe CP ( C hest P ain ).

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Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

ACEP Now

3 A three-pronged management approach provides a framework for addressing post-tonsillectomy bleeds: resuscitation, early ENT consultation with transport arrangements, and temporizing measures applied to control bleeding. Special thanks to Dr. Kevin Wasko, guest expert on the EM Cases podcast on this topic, who inspired this column.

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How Long Should EM Residency Be? New Studies Shed Light

ACEP Now

emergency medicine (EM) residency training length has been a decades-long dilemma: four vs. three years. First, is three years enough time to become an EM physician? But critical questions remain unanswered when it comes to specialization, career trajectory, and actual competence as an EM physician. 11 What should we take away?

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