Acute, non-traumatic low back pain (LBP) is a common chief complaint and has been estimated to lead to more than 2.7 million ED visits annually nationwide. It affects a broad range of individuals and can be painful and debilitating long after an initial ED visit. Often times in clinical practice, evidence based decisions on medical management of acute lower back pain seem to be thrown out the window;
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Journal Review
Treatment of Acute, Non-Traumatic Low Back Pain
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Teaching Risk Taking Behavior in EM
This post was previously published on iTeachEM on 9/22/14 here.
A 44-year-old healthy man presents with dull chest pain for 3 hours. His EKG is unremarkable. What’s his risk for acute coronary syndrome? Should he get a troponin? Two troponins? Observation and a stress test?
Emergency Medicine is an inherently risky specialty.
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Journal Review
The Predictive Ability of the FAST Examination in Traumatic Cardiac Arrest
Resuscitative thoracotomy (RT) performed in the Emergency Department (ED) is a potentially life-saving procedure in patients with traumatic cardiac arrest. However, the procedure does have the potential to harm providers (i.e. fluid exposure). Therefore, it is important to weight two different perspectives: the patient is dead and will remain so if an RT is not performed so why not try it as a last ditch effort and that RT is low yield so why expend resources and create a potential risk of harm to providers.
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Spinal Epidural Abscess
Spinal epidural abscess is a rare, life-threatening disorder. Early recognition is key. Post reviews presentation, diagnosis + management
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On the Trail – An MS IV’s Perspective on Residency Interviews
Program Director – “So what are you looking for in a residency program?” Interviewee – “Well let’s begin by discussing the lunch spread during Wednesday conference.” NOTE: do not say this during your actual interview.
Having completed about half my interviews at this point, I still struggle when program directors ask me this question.
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Journal Review
Prophylactic Antibiotics in Fingertip Amputations
Fingertip amputations are common. Treatment options range from healing by secondary intention to flap coverage or replantation. Selection of the appropriate treatment modality depends on the nature of the injury, the physical demands of the patient, and the patient’s co-morbidities. Prophylactic antibiotic use in patients with fingertip amputations is controversial. The routine use of prophylactic antibiotics is universally recommended on grossly contaminated wounds,
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Vertebral Osteomyelitis
Vertebral osteomyelitis is a rare disorder characterized by inflammation of the vertebrae. Recognition can be difficult + delayed.
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