Contributor; Aaron Lessen, MD Educational Pearls: A 2026 survey asked Canadian emergency medicine (EM) physicians about their eating and drinking habits while on shift. Among 527 respondents, 35% reported that they never or hardly ever ate during shifts, and 37% said the same about drinking water Lack of time was the most commonly cited barrier,…
Read MoreContributor: Alec Coston, MD Educational Pearls: Disclaimer: this has nothing to do with the ER but is too cool to not talk about. Condition: Carbamoyl phosphate synthetase 1 (CPS1) deficiency Rare inborn error of metabolism Inability to properly break down ammonia Leads to severe hyperammonemia and hepatic encephalopathy Natural history: Without treatment, typically fatal within…
Read MoreContributor: Aaron Lessen, MD Educational Pearls BRASH Syndrome: Bradycardia Renal Failure AV Nodal Blockade Shock Hyperkalemia Clinical Features: Profound bradycardia and shock in patients on AV nodal blockers: Commonly, Beta Blockers or Calcium Channel Blockers Etiology: Caused by an inciting kidney injury: Common triggers include precipitating illness, dehydration, or medications Results in hyperkalemia The enhanced…
Read MoreContributors: Col. (Dr.) Stacy Shackelford Dr. Sean Keenan Paramedic Alan Moreland Dr. Chris Tems Kara Napolitano From military-inspired trauma protocols to behavioral health alternatives and cardiac resuscitation, EMS is evolving fast. Our Medical Minutes from EMSAC highlight the growing need for prehospital providers to think critically, act quickly, and adapt to new approaches in trauma,…
Read MoreIn addition to producing our own content, we believe in using our platform to amplify other voices and perspectives in medicine. With that in mind, check out ‘The Black Doctor Podcast’ from Dr. Steven Bradley which features interviews with leading minority professionals of the current generation as well as stories of how they overcame adversity…
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Coronavirus Testing Chief Complaint: SOB HPI: 43 year-old male anesthesiologist presents to the ED with increasing shortness of breath, tachycardia and lethargy. Patient reports alternating positive and negative COVID tests since early March, job related exposure, as well as travel to Belize and twice to Summit County (considered a hotspot for COVID) since early March….
Read MoreHost: Elizabeth Esty, MD. At this point, with so many of the studies we’ve digested exploring correlations, associations, observational studies and anecdotal reports and speculation, we could subtitle the show: what we don’t know about COVID. And so, today, we’ll look at what we don’t know about Vitamin D and COVID. There have been a number of…
Read MoreHost: Elizabeth Esty, MD. Smoking is known to increase both susceptibility and severity of all manner of colds and pneumonias, so you’d think the world’s 1.1 billion smokers would be at risk in this pandemic of what at first seemed to be a just a respiratory virus. What’s more, tobacco smoking increases risk for COPD,…
Read MoreHost: Elizabeth Esty, MD Last week we looked at neurologic presentations of COVID-19; this week we’ll look more closely at strokes in young people with COVID. A letter published 2 days ago in the NEJM with lead author Thomas Oxley, the Neuro ICU director at Mt Sinai, presents five case studies of relatively young patients…
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a typical case of the pandemic Chief Complaint: Altered Mental Status HPI: 69-year-old male with history of diabetes brought in by his son to the emergency department with altered mental status. Patient is unresponsive and all history is from his son and chart review. Son reports that he had increasing shortness of breath and confusion…
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