At one point in history, measles was a common childhood illness, like the chicken pox of my youth. Thankfully the incidence has significantly decreased with vaccination, but the illness is now resurfacing in the face of vaccine hesitancy. Would you be able to identify and manage measles if it walked […]
Clinician gestalt is one of those terms that people either love or hate. Lovers will point out how, almost every time that it is studied, gestalt is at least as accurate as validated clinical decision tools. Haters will lament the inclusion of gestalt in decision tools like the Well’s score, […]
This month, I was honoured to be invited back on Dr. Jeannette Wolfe’s incredible podcast “seX and whY”. We chatted about a couple papers that looked at sex differences in the management and outcomes of cardiac arrest and STEMI. This is a brief summary of the papers we discussed.
I walk into the room and see a 3 year old screaming in pain. It’s 3 am and her ear hurts. She couldn’t sleep. I ask her father what he has been using at home for pain. He pulls out a box and my heart sinks. Another parent duped by […]
Here is another collection of the articles I have found interesting in my reading from the last month or so. For this edition of the Research Roundup we have status epilepticus, nocebos, the pink lady, McGyver bias, and so much more. Podcast version over on BroomeDocs.
This will be the final post this week about status epilepticus. I have long argued that our current status algorithms leave too many patients seizing for too long. I updated my suggested alternative algorithm this week and added a longer supplemental post explaining the reasons that I suggest early anesthetic […]
My approach to status epilepticus is somewhat more aggressive than commonly taught algorithms. It is summarized (overly simply) as “benzo → benzo → propofol”. There have been a number of concerns raised with this strategy recently on twitter. This post outlines the reasoning (and limited evidence) behind my seizure algorithm.
Case EMS arrives with a 39 year old woman in the midst of a generalized tonic clonic seizure. The seizure has lasted at least 12 minutes now, so this is status epilepticus. No information is available about her past history. The paramedics were unable to start an IV, but did […]
Hemoptysis can be scary. I covered the emergency medicine approach to massive hemoptysis in one of the early posts on First10EM. However, even when the hemoptysis is small volume, it can be quite distressing to patients and clinicians alike. This paper asks whether using nebulized tranexamic acid (or TXA) for […]