Vascular , Pediatric EM

Hand, Meet Autoinjector: Ouch!

10/10/2023 Nikhil Mohan, DO, FACEP , Paul Truong, DO

Digital ischemia after accidental injection of an epinephrine autoinjector can be treated with subcutaneous terbutaline injection. Terbutaline is a selective beta-2-agonist, resulting in vasodilation.

Op-Ed , Social EM

Caring for Immigrants in the ED: A Quick Guide

10/10/2023 Molly Curtiss DO , Carolina Ornelas-Dorian MD , Tuong Pham, MD

The ED is an important source of health care for immigrants and refugees/asylum seekers.1,2 Since the passing of EMTALA, the ED has functioned as the health care safety net for immigrants, especially

Ophthalmology

A Rare Case: Atraumatic, Anterior Segment Ophthalmologic Hemorrhage Requiring Anticoagulation Reversal

10/10/2023 Elijah Abramson, MD , Darius Felton, MD , Solly Elmann , Theodore Gaeta, DO, FACEP

Warfarin-induced spontaneous subconjunctival hemorrhage has been identified in the literature. Clinical judgment should guide emergent reversal of potentially sight-threatening ophthalmologic hemorrha

ECG Challenge , Cardiology

ECG Challenge: Oct-Nov-Dec 2023

10/10/2023 Usama Khan, MD , Jeremy Berberian, MD

A 54-year-old male with a past medical history significant for primary CNS B-cell lymphoma, on chemotherapy and lacosamide for seizure prophylaxis, was admitted to the ICU for hypoxia and neutropenic

Critical Care Alert , Critical Care , Pulmonary , Cardiology , Neurology

Critical Care Alert: TAME Trial: Mild Hypercapnia versus Normocapnia after Out-of-Hospital Cardiac Arrest

9/29/2023 ThucAn Bui, DO , Evan McMurray, MD

This Critical Care Alert examines a study of targeted mild hypercapnia versus normocapnia for patients who achieved ROSC after out-of-hospital cardiac arrest.

Endocrinology

Cloudy With a Chance of Thyroid Storm: A “Grave” Condition

9/15/2023 Alexa Van Besien, MD , Rakhi Desai, MD , Laura Welsh, MD , Andrew Mittelman, MD

Thyroid storm (TS) commonly occurs in patients with Graves’ disease. Its clinical manifestations overlap with many illnesses; therefore, diagnosis can be challenging. Prompt recognition and evaluation

Toxicology

The Dangers of Delta-8

9/15/2023 Brittany (Ladson) Garza, DO

Marijuana, THC (tetrahydrocannabinol), and CBD (cannabidiol) products are becoming increasingly popularized and legalized in our society. With the proliferation of these products’ use also comes accid

Critical Care Alert , Critical Care , Neurology

Critical Care Alert: Tranexamic Acid for Intracerebral Hemorrhage in Patients on Non-Vitamin K Antagonist Oral Anticoagulants (TICH-NOAC)

9/10/2023 Cassidy Cunningham, DO , Evan McMurray, MD

In this underpowered RCT, no evidence was found that TXA limits HE nor that it improves clinical outcomes by 90 days in NOAC-associated ICH. That being said, there were no major safety concerns noted

Pain Management

Effective and Safe Opioid Dosing for Opioid-Tolerant Patients in the ED

9/10/2023 Alexander Steele, MD , Leonie Oostrom-Shah, MD , Brian Gacioch, MD, FACEP, FAAEM , Rita A. Manfredi, MD, FACEP

In patients with advanced cancer, the combination of disease progression over time, as well as habituation to chronic opioids, often leads to the need to increase opioid dosing over the course of illn

Critical Care Alert , Critical Care , Airway

Critical Care Alert: Video v. Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults: The DEVICE Trial

8/3/2023 Gabriel Colon, MD , Alexandra Hallagan, MD , Evan McMurray, MD

More evidence is stacking up in favor of video laryngoscopy. The DEVICE Trial shows that when intubating critically ill patients in the ED or ICU, consider using video over direct laryngoscopy to impr

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