August 2014 archive

Anna Yaffee 52 in 52: Two Brief Articles on Ureteral Calculi

Coll, Deirdre M, Michael J Varanelli, and Robert C Smith. “Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT.” American Journal Of Roentgenology 178.1 (2002) : 1644. Take Home Points: Spontaneous passage rate of ureteral calculi varies depending on size and location Size: 87% of stones 1mm in …

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Dr. Anna Yaffee: 52 in 52: Chemical Restraint

Anna Yaffee Recent articles 52 in 52: Nobay et al. 2004. A prospective, double-blind, randomized trial of midazolam vs haloperidol vs lorazepam in the chemical restraint of violent and severely agitated patients. Acad Emerg Med. 11(7): 744-749. Take home point: In this double-blind, randomized trial of 111 violent and severely agitated patients in a county …

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Pregnant with headache

Presentation:  37 yo F with progressive headache, R hand tingling, and incidentally found on this ER visit to be pregnant.  Top 5 Teaching Points Cerebral Vein Thrombosis (1):  1)      It’s rare:  about 1:100,000 in a year (but about 11:100,000 in pregnant women) 2)      Pt’s present with a progressively worsening localizing headache over days (as venous …

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52 in 52: Airway Assessment Score

In preparation for airway simulation lab, we read: Reed MJ, Dunn MJG, McKeown DW. 2005. Can an airway assessment score predict difficulty at intubation in the emergency department? Emerg Med J. 22(2):99-102. Take home points: LEMON criteria:  (L- Look externally for characteristics known to cause difficulty; E- Evaluate the 3-3-2 rule; M- Mallampati; O- Obstruction; …

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Traumatic Aortic Dissections

Aortic Dissection is one of those diagnoses that gets everyone’s heart rates up (despite beta blockers), and its something we (should) think about in all of our blunt trauma patients. The proximal descending aorta is the great vessel most susceptible injury in blunt trauma, due to its relative mobility over the fixed abdominal aorta, which …

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RUQ Pain

Presentation:  46 yo M with 2 day hx of RUQ pain and n/v.  Taking Tylenol for pain.   PE:  VS NL, appears distressed, + TTP in RUQ and epigastrium Workup:  RUQ US:  showing sludge in gall bladder, no stones, no pericholecystic fluid and the wall was not thickened.  However, the common bile duct was dilated to 8mm …

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