Tactical Medicine News Blog
Emergency Medicine factoids on Twitter
Posted by Michelle Lin, MD on
The medical profession is slowly incorporating Twitter. If you have a Twitter account, here are some great Twitter accounts to follow:
Paucis Verbis: Cardiac tamponade or just an effusion?
Posted by Michelle Lin, MD on
What is a cardiac tamponade? It is a clinical state where pericardial fluid causes hemodynamic compromise. With bedside ultrasonography in most Emergency Departments now, it’s relatively easy to detect a pericardial effusion. But what we more want to know in the immediate setting is: Is this cardiac tamponade? You can look for RA systolic or RV diastolic collapse. What if it’s equivocal? How good is the clinical exam and EKG in ruling out a tamponade?
Trick of the Trade: Epistaxis control with tongue blades
Posted by Michelle Lin, MD on
For epistaxis, the classic teaching is to pinch the nose to control the bleeding. A persistent nosebleed often is the result of one’s natural inclination to constantly check if there is still bleeding every few seconds. Applying pressure on-and-off makes it difficult for the bleeding to stop.
A faculty’s perspective: Doing well on your EM clerkship
Posted by Michelle Lin, MD on
To follow-up with Dr. Connolly’s perspective about the Top 10 tips for medical students to rock the EM clerkship rotation, I thought I would post some additional tips. Here are some more pearls: 11. Take ownership of your patients. This means that you should take it upon yourself to make sure that your patient’s care is stellar, addresses key clinical and social issues, and is timely. Constantly check for your patient’s results. Don’t be the last to hear of your patient’s lab or imaging results. Figure out why there are unexpected delays. Address any psychosocial issues which may hamper your patient’s clinical improvement in the ED.
Paucis Verbis: Blunt cerebrovascular injuries
Posted by Michelle Lin, MD on
In the setting of blunt trauma, it is easily to overlook a patient’s risk for blunt cerebrovascular injuries (BCVI). These are injuries to the carotid and vertebral arteries. Often they are asymptomatic with the initial injury, but the goal is to detect them before they develop a delayed stroke. Who are at risk for these injuries? What kind of imaging should I order to rule these injuries out? Do I really treat these patients with antithrombotic agents even in the setting of trauma to reduce the incidence of CVA?