With blunt head trauma, the most frequent question is: “CT brain or no CT brain”: The Head CT in Trauma (clinical decision rule) will help you make your decision.
Other useful guides:
… Read moreAuthor: Dan Ostermayer
Complicated Deliveries in the ED
Before your next precipitous delivery arrives in the ED, take a moment to review these important pages for:
… Read moreNew Senior Assistant Editor – Michael Holtz
Congratulations to Dr. Michael Holtz on promoting to Senior Assistant Editor.… Read more
Recognizing our editors
There have been a lot of promotions among the core editorial group at WikEM. Without our highly skilled editorial team and the daily contributors, a global emergency medicine knowledge repository would not be possible. Thank you all! Also, all donations to our organization allow us to continue to improve the software for the world to use for free.… Read more
Antibiotics by Diagnosis
Antibiotics are hard to remember and during a busy shift we all just want a quick place to refresh our memory. The quick reference by system diagnosis provides a list of all the major treatments across the wiki. Updating a dosing or adding alternative treatments will update the antibiotic on all necessary pages and allow the world free and up to date access to antibiotic dosing.
June Newsletter
The June Newsletter is out. Topics include hemophilia, Lyme disease, mammalian bites, and arthritis.… Read more
Telemetry Monitoring: Who needs it?
Which of the following patients does not warrant monitoring with telemetry after admission to the hospital?
A. AICD firing
B. Type II and complete heart block
C. Decompensated heart failure
D. Acute cerebrovascular accident
E. Massive blood transfusion
F. All of the above warrant monitoring
…an excerpt from The Kaji Review
Reference:
LLSA 2009: Chen EH and Hollander JE. When do patients need admission to a telemetry bed? J Emerg Med. 2007; 33(1): 53-60. full text… Read more
Vasopressors
The goal of vasopressor use is to reach critical organ perfusion pressure. Estimated required mean arterial pressures (MAP) are listed in the vasopressor review by organ. It is generally safe to aim for a goal map of 65 mmHg. Vasopressors also promote increased venous return and should be used in septic patients after failed response to adequate volume resuscitation.… Read more
Thryoid Storm
Scott Weingart has put out a great EMCrit Podcast on the treatment and diagnosis of Thyroid Storm. With thyrotoxicosis and thyroid storm being relatively rare diseases, wiki page highlights the treatment and diagnosis. The severity of hyperthyroidism, thyrotoxicosis and thyroid storm can be assessed with the Burch-Wartofsky score. Treatment is focused on: Aggressive supportive care and early propranolol administration to decrease peripheral hormone conversion and decrease sympathetic surge. Also along with propranolol, thionamide administration (specifically PTU) blocks new hormone synthesis. Iodide can be administered afterwards to prevent further hormone production.… Read more
Treatment of Ureteral Calculi
Regarding ureteral calculi, which of the following is FALSE?
A. The incidence of kidney stones in the general population appears to be increasing, as does the medical cost associated with this disease.
B. The majority of individuals with urolithiasis have small (<5 mm) stones, located in the distal ureter, that are able to pass spontaneously.
C. Both stone expulsion and time to expulsion of ureteral stones depend heavily on stone size and location.
D. Urologic intervention is recommended for ureteral stones that persist for more than 2 months.
E. A meta-analysis demonstrated that neither calcium channel blockers nor alpha-antagonists increase the rate of stone passage.
excerpt from The Kaji Review … Read more