Contributor: Aaron Lessen MD Educational Pearls: 33 Medical residents and 91 nurses at Massachusetts General Hospital were randomized into two groups: Intervention group: 15 PGY-1 residents assigned to the same medical service floor for a 16-week period (12 weeks after adjustment for COVID-19 restrictions) alongside 43 nurses. Control group: 18 PGY-1 residents assigned to the…
Read MoreContributor: Meghan Hurley MD Educational Pearls: What do you do if you need a stat pregnancy test on an incapacitated patient? You can send a serum quantitative human chorionic gonadotropin (beta-HCG), but that might take a while for the lab to process. Another option is to place a drop of whole blood on a urine…
Read MoreContributor: Chris Holmes MD Educational Pearls: “It’s a poor sort of memory that only works backwards” – Transient Global Amnesia A syndrome with sudden retrograde memory loss in which patients cannot retain new information Characterized by perseveration in frequent intervals Typically improves within hours MRI is normal initially Alice In Wonderland Syndrome A disorder in…
Read MoreContributor: Nicholas Tsipis, MD Educational Pearls: What study was Dr. Tsipis talking about? In December of 2022, the Agency for Healthcare Research and Quality (AHRQ) put out a study titled “Diagnostic Errors in the Emergency Department: A Systematic Review.” This study triggered many news stories from prominent outlets with headlines such as, “More than 7…
Read MoreContributor: Travis Barlock MD Educational Pearls The QT interval represents phases 2 and 3 of ventricular plateau and repolarization, respectively. As the QT interval lengthens, more sodium and calcium channels are available and susceptible to action potentials. Prolonged QT interval is more concerning in the setting of bradycardia. This scenario increases the likelihood of R…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: What is Tranq? Tranq is the street name for xylazine, a sedative drug typically used in veterinary medicine. Xylazine has recently emerged as a recreational drug, often mixed with heroin or fentanyl. The mechanism of action of xylazine is similar to dexmedetomidine (Precedex), an alpha-2 adrenergic receptor agonist. At…
Read MoreContributor: Travis Barlock MD Educational Pearls: Three categories of pressors: inopressors, pure vasoconstrictors, and inodilators Inopressors: Epinephrine – nonselective beta- and alpha-adrenergic agonism, leading to increased cardiac contractility, chronotropy (increased heart rate), and peripheral vasoconstriction. Dose 0.1mcg/kg/min. Levophed (norepinephrine) – more vasoconstriction peripherally than inotropy; useful in most cases of shock. Dose 0.1mcg/kg/min. Peripheral vasoconstrictors:…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: What is thrombolysis? Thrombolysis is performed by administration of a medication that promotes the body’s natural ability to break up clots. These medications include Alteplase (tPA) and Tenecteplase (TNK). The main side effect of using such an agent is bleeding which typically occurs at puncture sites but can also…
Read MoreContributor: Aaron Lessen MD Educational Pearls: SCAPE (Sympathetic Crashing Acute Pulmonary Edema), formerly known as flash pulmonary edema, is a life-threatening condition due to a sudden sympathetic surge that leads to hypertensive heart failure, pulmonary edema, hypoxia, and respiratory distress. The initial treatment for SCAPE stabilization is BiPAP to assist with ventilation. Pharmacological treatment for…
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