New Kid on The HyperK Block… Lokelma
Lokelma (Zirconium Cyclosilicate) I’m sure everyone has seen our new friend, Lokelma, on the Rush hyperkalemia order set. Thought it would be fun to do a blog post to discuss…
Aortic Dissection
Intro We had an awesome lecture by Dr. K Gore this past week–this blog is a quick review of her lecture on aortic dissection. Background An aortic dissection (AD) is…
Wide Complex Tachycardia
Intro
There’s an old adage that wide complex tachycardia is VTach until proven otherwise. While this is true as do not want to miss any potentially lethal arrhythmia, it is also important to understand the differential for wide complex tachycardias so that we can tailor our potential treatments to the specific arrhythmia. It is also important to note that in any unstable patient with a wide complex tachycardia (or narrow complex tachycardia) that electricity is always safe.
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Narrow Complex Tachycardias
Intro
The differential for narrow complex tachycardia is extremely important as it is the most commonly seen abnormal EKG in the emergency department. It includes rhythms such as sinus tachycardia, AVnRT, AVRT, atrial flutter, ectopic atrial tachycardia (EAT), atrial fibrillation, atrial flutter, and multifocal atrial tachycardia (MAT).
The goal of this blog is to run through this differential and give some methods to differentiate the rhythms. Although we will not delve too deep into antiarrhythmics, it is important to note that electricity is safe in all unstable rhythms no matter the etiology.
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Pediatric Urologic Emergencies
In this blog, we’re going to dive into the topic of pediatric urologic emergencies. We’re going to focus on some of the more uncommon emergencies such as: phimosis, paraphimosis, priapism, entrapment injuries, testicular torsion, epididymitis, varicocele, and hydrocele. It’s important to note that UTI’s and Kidney stones are also common in peds, and often require additional work-up as often indicate abnormal anatomy or disease processes.
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The Limping Child
Background
Most children begin walking between 12 and 18 months. Their initial gait starts broad-based, often with short asymmetric steps. At faster speeds, they often develop foot slapping and asymmetric arm swinging. By ages 3-5 years-old, children start to walk with more fluidity and symmetric strides. By ages 5-7 years-old, their gait begins to resemble the same pattern as an adult.…
Massive Transfusion Protocol
Intro
This blog post covers identifying the need for MTP, MTP protocol, goals of therapy, evidence behind MTP, adjuncts to MTP, and newer testing for coagulopathy. There is also a review of blood transfusion reactions.
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Bleeding AV Access
Bleeding AV Access
Background
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Most often occurs at dialysis center after fistula site is accessed
- Presents as punctate bleed overlying fistula. Can be slow oozing bleed from uremia or high-pressure bleed similar to arterial bleed
- Slow oozing bleed is less common in ED as hemostasis is often achieved at dialysis center
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5 Minute Journal: PECARN Head CT Rule
PECARN Head CT Rule
Dr. Brian Yu did a great 5-minute summary on the PECARN head CT Rule that was published in 2009. It’s an ambitious study that involved 25 emergency departments and included 42,412 patients under the age of 18 years who presented with blunt head trauma. It further risk stratified these patients into 2 major cohorts of <2 years of age and 2-18 years of age. It excluded patients with trivial injury, penetrating trauma, neurologic history, and those with prior imaging. The outcomes this study aimed for were clinically important findings including death, need for neurosurgical intervention, intubation >24 hours, and admission >2 nights. …
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