Steroid Selection In Pediatric Asthma

Pediatric asthma exacerbations account for a significant portion of trips to the emergency department (ED), comprising 2-4.5% of ED visits each year. As a common disease of the pediatric population, effective ED management is key. The current mainstay of treatment is beta-agonist and corticosteroid administration. Here we discuss the evidence behind steroid selection in the pediatric asthmatic presenting to the emergency department. 

The GRIEV_ING MNEMONIC: A Simple Approach To Death Notification In The ED

 Death notification in the ED is not easy. Using the simple steps in the GRIEV_ING mnemonic, Dr. Hobgood found a significant increase in residents’ confidence with and competence in delivering a death notification. Here we simplify how to incorporate this effectively into your practice. 

LVAD Management In The ED

Left Ventricular Assist Devices (LVADs) are surgically implanted pumps that essentially “take over” the job of the failing left ventricle, restoring normal blood flow to the body. While they sound complicated, learning a few key pearls can help you successfully management LVAD patients in your emergency department.

Quick Guide To Minor Facial Trauma: Part 2

In the emergency department, we commonly encounter minor injuries to the face and mouth.  In a two part series, we will provide a short overview of some helpful strategies for dealing with these cosmetically sensitive injuries in an effective manner. 

Owning The Ankle Arthrocentesis

As ER doctors, we stick a lot of needles into a lot of different body parts. Sometimes into vessels, sometimes into the area around the spinal cord, and of course, sometimes into hot, swollen joints. The ankle is included in this which can often prove difficult to access. To help you through your next angry ankle, here are a couple of pointers.

Incorporating Diagnostic Testing Into Your Clinical Decisions

Understanding the mathematical breakdown of how we incorporate testing into our medical decisions is tough. This post will provide you with some structure and understanding into the processes behind the decisions you make and the tests you order. 

Quick Guide to Minor Facial Trauma: Part I

In the emergency department, we commonly encounter minor injuries to the face and mouth.  In a two part series, we will provide a short overview of some helpful strategies for dealing with these cosmetically sensitive injuries in an effective manner. 

Ovarian Hyperstimulation: Not Your Ovarian Average Cyst

Pregnancies resulting from assisted reproduction are more complicated, with higher rates of ectopic, heterotopic and multifetal pregnancies, in addition to higher rates of abortions and premature deliveries. Other complications include venous thromboembolism as well as ovarian hyperstimulation syndrome. These are high risk pregnancies that will present to your emergency department and you should be aware of key management principles. 

Complications of Central Venous Catheters

We review the recent randomized-controlled trial by Parienti et al in the New England Journal of Medicine which sought to determine the complication rate of central venous catheters (CVC) at the 3 primary sites of insertion. 

Transfusion Reactions In The ED

Blood products, despite what may be commonly believed, are a scarce and valuable resource.  While overall, there are many systems to ensure the safety of the products, any transfusion poses a certain degree of risk. We review the spectrum of transfusion reactions, from the common to the uncommon. 

Journal Club: Coronary CT Angiography Versus Traditional Care

Coronary CT Angiography (CCTA) has shown promise in three major randomized controlled trials evaluating its safety in risk-stratifying low- to intermediate-risk patients. Additionally, CCTA-based screening was shown to increase rate of discharge directly from the ED, and decreased length of stay. The study discussed in this Journal Club Review contributes to the growing body of evidence regarding use of  CCTA and its role in screening patients with lower risk chest pain.