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Morning Report 7/13

Morning Report by @TedKoko @skornweiss about the febrile neonate. @ALiEMteam @emergencypdx @emergencydocs @WikEM_org @PEMEDpodcast #FOAMed

Today’s morning report was about a 4 week old with a fever, hypotension, and tachycardia. We discussed neonatal sepsis and the workup of the febrile neonate. Remember that your workup for the febrile neonate depends on age. From 0-28 days – do everything every time. This means blood and urine cultures, LP, chest xray, ampicillin and cefotaxime; vancomycin and acyclovir to be considered. From…

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#fever #neonate #pediatrics #sepsis

Landmark Article of the Week

Landmark Article of the Week - NIPPV for COPD. @emcrit @embasic @nejm #FOAMed

NIPPV for COPD Thanks to Dr. Philippe Louissaint for writing this post and sharing the second weekly landmark article. An oldie but a goodie… Brochard, L., Mancebo, J., Wysocki, M., Lofaso, F., Conti, G., Rauss, A., … Harf, A. (1995). Noninvasive Ventilation for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. New England Journal of Medicine, 333(13), 817–822. Summary The second…

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#article-of-the-week #copd #nippv

Morning Report by @tedkoko

Morning Report by @tedkoko #FOAMed

Case Presentation 57 yr old M with a history of CAD, hypothyroidism and HTN presents to the emergency department with palpitations. He reports that the palpitations began this morning at 5 AM. He denies any chest pain, nausea or vomiting and states he has had some intermittent lightheadedness with these symptoms. Examination You see a middle aged male who is ill appearing, pale and in moderate…

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#morning report #procainamide #Vtach

FOAM Resource of the Month

FOAM Resource of the Month - http://emergencymedicineireland.com/ @andyneill #FOAMed

http://emergencymedicineireland.com/ This site was created and is managed by @andyneill, an EP in Ireland. One of his newer posts on the eye is an excellent review of ocular anatomy and physiology. (more…)

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#foam-of-the-month #foam-resource

Article of the Week - Tidal Volume and ARDs

Article of the Week - TV and #ARDs #FOAMed @critcarereviews @precordialthump

This article is the first in our annual series of weekly articles which will be distributed both via email and on the website here as blog posts. This article was published in 2000 in NEJM by the ARDS Network and compared tidal volumes of initial tidal volumes of 6ml/kg versus the traditional tidal volume of 12ml/kg and found a statistically significant reduction in mortality prior to discharge…

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#ards #article-of-the-week #critical-care #ventilator

Wayne's EKG Series Numero Ocho

Wayne's EKG Series Numero Ocho - Bradycardia @wblmd

Case Presentation A female patient in her 70s presents with 2 episodes of syncope while seated. The patient denies head injury or trauma, and is currently asymptomatic, without chest pain, sob, or palpitations. BP 143/73 HR 63 RR 18 O2 Sat on RA 98% Temp 97.3F Palpable Pulse: 30s well appearing; nad, aaox3 remainder of exam: normal Initial EKG: Q1: what rhythm do you see here? Interventions: Labs…

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#bradycardia #cardiology #ECG #ekg #wayne&039;s-ekg-world

Morning Report by TeKo and CoHo - 6/23

Morning Report by TeKo and CoHo - 6/23 @choran418 @tedkoko @MPerMare @coleary523

57 yr old M with a history of DMII and HTN presents to the emergency department with epigastric abdominal pain. Pt states his pain began one day ago. Pain is associated with nausea and a few episodes of non-bloody, non bilious emesis. Pt reports compliance with his oral diabetes medication, missing only today’s dose due to nausea. Pt denies any other symptoms. Pt is placed on a monitor. A…

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#abdominal pain #ekg #morning report

Welcome to the unofficial website of the Thomas Jefferson University Hospital Emergency Medicine Program. Please also visit the official hospital website.

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#home

Post Strep GN

History

A 6 year old boy presents with multiple episodes of dark urine today. Patient is otherwise in good health and denies any dysuria or urinary frequency. He has no history of similar episodes and was born full term with no complications.

Vital signs obtained by the nurse indicate a blood pressure of 143/96 with a pulse of 75 and temperature of 98.5. She requests that you see the patient…

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Featured FOAM resource of the month

Erowid.org

This website is a fantastic resource for everything you ever did…or did not want to know about psychoactive drugs. Whether you are curious about the chemical composition of any number of psychoactive substances or want up to date information on the legal status of a wide variety of chemical compounds, or perhaps you just want to know the difference between a an abbot and a bag…

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ED 2.0 Save the date

Pediatric Refractory Ventricular Fibrillation

Case: Pediatric Refractory Ventricular Fibrillation #FOAMed @PedEMMorsels @commotio_cordis

Thank you to our own Ross Simcoe MD for submitting a case-report on which this is based 12 year old M is struck in the chest by a baseball, falls to the ground instantly, and is subsequently unresponsive. ALS arrives and he is found to be in pulseless VF. Defibrillation achieves ROSC and the patient is transferred to a local ED. The patient has recurrent Vfib and is defibrillated again in order…

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#cardiology #commotio-cordis #pediatrics #vfib

Congrats to all

Congrats all EM residents on completing the inservice exam!!!!

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EMRA and Inservice Update

EMRA and Inservice Update #FOAMed @emresidents

Hello Fellow Residents,

I want to wish you all well and hope that you are staying warm despite the cold winter. While the days are short and the nights are long, and it’s cold and dreary and dark out, before you know it, spring will be here. Here are some updates within EMRA:

(more…)

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Featured FOAM Resource of the Month

Featured FOAM Resource of the Month: http://shoulderdislocation.net/ @GetMyShoulderIn #FOAMed

Shoulderdislocation.netThis website is a fantastic online resource for everything shoulder dislocation. Whether you’re trying to tell the difference between a Hill-Sachs and a Bankart lesion, or watch one of the many videos demonstrating in detail how to reduce shoulder dislocations, this website will have helpful information to improve your management. Throughout the website, Dr. Cunningham and…

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#cunningham #orthopedics #shoulder-dislocation

Headache, URI symptoms and ataxia in a 9 y F. #FOAMed

An interesting case of pediatric headache and ataxia

Thanks to our own Ross Simcoe, MD for providing this case history

HPI

A 9 yo female with pmhx of autism and migraine headaches presents with a headache that began 5 days ago upon awakening, NBNB emesis 3-4x/day and gait ataxia 5 days after the resolution of a 2 day period of rhinorrhea, congestion and emesis. The pain is frontal, constant,…

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#neurology #pediatrics

Bradycardia

Compliments of our own Richard Ian Rossfrye, M.D. A Review of Bradycardia: diagnosis and management Highlights within this text:

Mnemonics to remember etiologies

Management

Overdoses: CCB, BB

EKG examples

High yield information on pacing

High yield references

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#bradycardia #cardiology

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