Clearance of suspected c-spine injuries specifically in AMS is one of the challenging topics in trauma. How do you clear C-spine in obtunded patient? well, as you know there are 2 methods: MRI or/and Flex-ex xray.There is a new study published in Annals of Internal Medicine in March: Cervical Spine Clearance in Obtunded Patients After […]. Continue Reading ...

What is your choice of IM medication for a patient who is very difficult to verbally be redirected, and being agitated, combative, and required to be sedated? Happy to see the old practice is still effective: Intramuscular Midazolam, Olanzapine, Ziprasidone, or Haloperidol for Treating Acute Agitation in the Emergency Department Ann Emerg Med. 2018 Jun […]. Continue Reading ...

We usually make fun of this topic such as how about have a ct scan in triage and etc.. This is a European study that shows the pan-scan algorithms reduce, but do not eliminate, the risk of missed injuries, and they should not replace close monitoring and clinical follow-up of patients with major trauma. Link […]. Continue Reading ...

Association between Type of Fluid Received Prior to Enrollment. The BaSICS Randomized Clinical Trial. Back to BaSICS: Early Treatments Matter in Critical Illness. The HINTS Exam. How to do Epley Maneuver Insertion of Transvenous Pacemaker. I-PASS. As discussed today, your symptoms require follow up within the next 1-2 days, and it is important to know how to keep safe from harming yourself or others. If you notice changes in your eating or sleeping habits, feeling unwilling or unable to communicate with others, discouragement or sadness, reckless behavior or withdrawal from people or activities, it is important to immediately call 911 or return to the ER. If you have any concerns about you or a loved one showing signs for self-harm, immediately call 911. You should abstain from alcohol or other intoxicants before further evaluation by a medical professional. Call the toll free National Suicide Prevention Hotlines if you ever feel the need to talk about your feelings, thoughts, or safety ...

There are bunch of rumors that come to play regarding what other medications we can use in cardiac arrest patient, Calcium, Sodium Bicarb, tPA,… A study published in JAMA tried to answer part of this question: "Effect of Intravenous or Intraosseous Calcium vs Saline on Return of Spontaneous Circulation in Adults With Out-of-Hospital Cardiac Arrest, […]. Continue Reading ...

I usually review a question on my board review series regarding a patient with trauma and negative x-ray of hip, what is the next step? The answer is usually CT scan, and I have to admit that this is my routine practice that I do not rely on X-ray, if my patient still is symptomatic,. Continue Reading ...

I am fan of Metoclopramide + Diphenhydramine or Prochlorperazine + Diphenhydramine for Migraine Headache, and I see a lot of good outcome among patients with headache. Annals of EM published "Diphenhydramine as Adjuvant Therapy for Acute Migraine: An Emergency Department-Based Randomized Clinical Trial". I am not sure that I am ready to start practicing this way but will take into consideration.. Link to article. ...