Cold, but not all that cold may be the way
SMACC Back 3 – Simon Carley on Leadership
A SMACC back on Simon Carley’s talk on Educational Leadership
A Study in Scarlet
A recent article published in the NEJM by Steg et al demonstrates that it is not the efficacy of an intervention that determines the success or failure of a trial, but rather the definition of its endpoints (1). In contrast to the majority of trials examining novel anticoagulants for ACS, Steg et al chose […]
EMCrit 110 – Exsanguinating Hemorrhage from Mid-Face Fractures
Management of Severe Hemorrhage from Mid-Face Blunt Trauma
Practical Evidence 013 – ACEP Management of Asymptomatic Blood Pressure 2013
Management of asymptomatic markedly elevated blood pressure
“The Adventure of the Veiled Lodger”
The HINTS exam is a 3-part test designed by Dr. Newman-Toker to clinically exclude a central cause of acute vertigo in patients who present with vertiginous symptoms. HINTS involves most famously, the head impulse test(see diagram below), a maneuver which involves torquing your patients head from midline to 20 degrees of rotation(or Vice Versa) and […]
“The Adventure of the Missing Three-Quarter”
Since Hector Pope published his now infamous study in the April 2000 NEJM, Emergency Physicians ability to clinically differentiate ACS has been called into question(10). Despite the fact the study’s findings that ED physicians missed an almost flawless 0.18% of chest pain patients who went on to be diagnosed with a MI, we have been […]
EMCrit 109 – Mind of the Resuscitationist from SMACC 2013
Mind of the Resuscitationist Lecture from SMACC 2013 and Blakemore Placement
Blakemore Tube Placement for Massive Upper GI Hemorrhage
How to place a Blakemore tube for esophageal varices with massive bleeding.
The Man with the Twisted Lip
As an Emergency Medicine doctor we are trained to function in varying degrees of uncertainty. We work in a world of risk of benefits vs harms. When the benefit to harm ratio reaches a threshold for action we are taught to do so swiftly and decisively. Given this, […]
EMCrit 108 – How to Be a Hero with Cliff Reid
This was my favorite lecture from SMACC 2013. If you are not moved and inspired then your heart is made of stone.
The Adventure of the Three Students
There are few things that make emergency medicine nerds more excited than decision rules. So when the Canadian gods of decision instruments, Jeff Perry and Ian Stiell, published the results from the validation cohort of their recently derived SAH decision rules they of course had our full attention. On September 25th 2013 JAMA published this […]
EMCrit 107 – Peripheral Vasopressor Infusions and Extravasation
Can we give vasopressors peripherally? And if we do, what if they leak?
The Sign of Four Part 2
On September 9th 2013 the article we have all been eagerly awaiting (or perhaps just myself!), was published in Circulation by Sarode et al (1). What was formerly known as Trial 3002 was officially named “Efficacy and Safety of a 4-factor Prothrombin Complex Concentrate in Patients on Vitamin K Antagonists Presenting with Major Bleeding”. Surprisingly […]
The Case of the Thirteen Watches
Door-to-balloon time is probably the most overstated, but least understood surrogate outcome measured in Emergency Medicine today. No sooner does the patient with midsternal chest pressure and ST elevations set foot in the emergency department, when they are packaged up and swept away to the cath lab by a gang of cardiology fellows and attendings. Now with […]
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