There are generally 3 main congenital heart diseases presentations that young children between ages of 0 days to about 3 months will present with.  Often times you will see experts split these congenital heart lesions into 2 categories: Cyanotic vs Acyanotic lesions. Either is an acceptable approach as long as you split the acyanotic lesions ... Read more

Background: Two prior trials compared the addition of vasopressin 20 IU (for each dose of epinephrine) and methylprednisolone 40mg to placebo for in hospital cardiac arrest. The 1st trial was published in 2009 [2] and the second in 2013 [3].  In the 2009 study, the combination of vasopressin-epinephrine and methylprednisolone improved survival.  In the 2013 ... Read more

Take home points: Epiglottitis has demonstrated a resurgence in the adult population. It is no longer a pediatric only disease. The classic presentation of epiglottitis (3Ds of drooling, dysphagia and distress) is uncommon Epiglottitis should be high on your differential for the bounce-back patient who continues to complain of worsening sore throat Definitive diagnosis is ... Read more

I was fortunate enough to record a podcast on Rob Orman’s, Stimulus podcast on Oct 14th, 2021.  We both felt it was an important enough topic that we should post it on both his and my site.  The treatment of non-hospitalized patients suffering from COVID-19 is a hot topic and constantly changing.  In this podcast ... Read more

Take-Home Points Always consider STEMI as the diagnosis prior to diagnosing pericarditis. If the EKG shows convex ST elevations, reciprocal ST depressions, or dynamic changes, the patient is much more likely to have a STEMI. Patients with pericarditis should be treated with a combination of NSAID/Aspirin and Colchicine Patients with large pericardial effusions, tachycardia out ... Read more

Background information: Buprenorphine and buprenorphine-containing medications are being used in emergency departments for treatment of patients with opioid use disorder (1). Buprenorphine is a high-affinity partial agonist of the μ-opioid receptor. Buprenorphine has a higher affinity for the μ-opioid receptor than full agonists such as heroin, oxycodone, fentanyl, and methadone. Thus, if a patient is ... Read more

REBEL Cast Book Club Episode 2: The New Jim Crow   Click here for Direct Download of Podcast Post Peer Reviewed By: Anand Swaminathan, MD (Twitter: @EMSwami) and Salim R. Rezaie, MD (Twitter: @srrezaie)

The reviewed article highlights the complex relationships between six themes:  Improving the processing of information Promoting effortful learning Applying learned information to new and varied contexts Developing expertise Harnessing the power of emotion for learning Teaching and learning in a social context. REBEL Core Cast 67.0 – Tips for Medical Education Click here for Direct ... Read more

Take Home Points Once you figure out the neonate that presented to your ED is sick, run through a differential of why then can be sick so you don’t anchor. I like to use TIMOT (Trauma, Infection, Metabolic, Organs, Tox) but use whatever works for you. Use your detailed history looking for risk factors to ... Read more

Background: The clinical importance of immediate coronary angiography after out of hospital cardiac arrest (OHCA) without STEMI continues to be debated. A systematic review and meta-analysis published in 2016 suggested that this set of patients has a high likelihood of having a culprit lesion when getting a catheterization. However, the studies included in this review ... Read more