Run Time: 2 minutes Author: Dr. Dylan Luyten Educational Pearls: Study looked at that IV catheter secured with Dermabond – studied the rate of failure within 48 hours, rate of dislodgment, rate of infection, rate of phlebitis, and pain. There was statistically significant lower rate of failure and dislodgment by 10% with Dermabond when compared…
Read MoreRun Time: 2 minutes Author: Dr. Christopher Holmes Educational Pearls: Prospective study of nurses health regarding rotating shift work (greater than or equal to 3 nights a week) found a mild increase in risk of cardiac issues. References: http://circ.ahajournals.org/content/92/11/3178.full
Read MoreRun Time: 6 minutes Author: Dr. Mark Kozlowski Educational Pearls: When preparing for a critical patient there are seven top preparations that are better to have in the room than to need in the room after their arrival. 1. EPOC 2. Glide Scope and Stylet (suction would also be very nice) 3. Ultrasound – in the…
Read MoreRun Time: 4 minutes Author: Dr. Mark Kozlowski Educational Pearls: Treat any pediatric patient first, call parents later! If a sixteen-year-old patient comes in to the ED for their child, the sixteen-year-old mother can consent to treatment of the child. Emancipated minors can consent for themselves. Minors can also consent for treatment for psychiatric related issues,…
Read MoreRun Time: 6 minutes Author: Dr. Eric Miller Educational Pearls: The QT interval is the time from the depolarization of the ventricle through the repolarization of the ventricle. Long QT increases the risk for dangerous dysrhythmias. The QTC – the corrected QT interval – abnormal is over 440ms for men and 460ms for women. Several…
Read MoreRun Time: 3 minutes Author: Dr. Mark Kozlowski Educational Pearls: NPO or nil per os is a medical instruction meaning the patient should not have any food or drink orally. At Vanderbilt Medical Center, the nursing staff initiated a change in the NPO status from everyone has to be NPO to no one needs to be…
Read MoreRun Time: 4 minutes Author: Rachael Duncan, PharmD BCPS Educational Pearls: Propranolol overdose presents with bradycardia, hypotension, decreased activity, and decreased body temperature. Propranolol is a lipophilic beta-blocker. Appropriate reversal agents for overdose on propranolol are epinephrine, dopamine, glucagon, calcium, levophed, and an IV lipid sink to sequester the propranolol. In cardiogenic shock, the heart begins…
Read MoreRun Time: 3 minutes Author: Dr. Samuel Killian Educational Pearls: Agitation – 16% of patients experience agitation with Ketamine. Aspiration – rare with 1 in 2500 cases exhibiting aspiration. Bradycardia – Happens most often with Etomidate, 1 in 250 cases. Hypotension – 2% of cases with Propofol – still less frequent than patients on a…
Read MoreRun Time: 2 minutes Author: Dr. Susan Brion Educational Pearls: Difficult patients include those who are rude, disruptive, or with multiple medical problems – 15% of patients qualify as difficult. In study in the British Medical Journal family practice resident were given 3 difficult patients and 3 normal patients. Residents misdiagnosed the difficult patients 42%…
Read MoreRun Time: 2 minutes Author: Dr. Christopher Holmes Educational Pearls: Old Sepsis criteria included 2 SIRS criteria – Temperature > 100.4°F, Heart Rate >90 bpm, Respiratory Rate >20, and White Blood Cell count > 12,000 mm3 – and a suspected source of infection. New Method involves SOFA – Sequencial Organ Failure Assessment scale – which…
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