Global Clues: The Essential Travel History for Febrile Patients
It’s 2 a.m. in the ED. The waiting room is full, and the next patient sounds straightforward: fever. Then they add, “I just got back from an international trip.”
Posts about Emergency Medicine
The New Indication for an MRI in the ED
I was working in one of our satellite EDs talking with an elderly patient and her daughter about some recent headaches and increased confusion. She was in her early 70s, with a history of Alzheimer’s Dementia (AD). After my initial evaluation and exam, I went back to my computer to place some orders. Looking over her chart, I noticed something odd; the patient had been getting MRIs of her brain every month.
Lower Back Pain Part 2: Treatment and Follow up
Last month, we started a two-part series on the evaluation and treatment of acute lower back pain (LBP) in the ED. This month, we are going to get into treatment options and how to help arrange follow-up care.
Teamwork Makes the Dream Work
Emergency medicine is a team sport. From physicians to nurses and respiratory therapists, every person on the shift has a role to play. When we work together, we get to help people navigate through their toughest moments (and occasionally, their worst decisions).
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Lower Back Pain: Pearls, Pitfalls, and Practical Tips
Whether you are working in primary care, urgent care, or the emergency department, chances are you see a patient complaining of lower back pain during every shift. It’s one of the most common reasons patients seek care, but also a chief complaint that leads to over-testing, over-treating, and is one of the driving factors behind the opioid epidemic.
IV Lidocaine for Renal Colic
Early in my career, I encountered a patient with severe renal colic who also had a history of opioid use disorder, now with several years of sobriety. Our initial treatment options with the usual non-narcotic medications and IV fluids had offered some initial relief, but his pain had returned with a vengeance. His battle with opioids had been hard fought, and he was adamant that he would only resort to opioids if we had exhausted every...
Introducing the Next Chapter of ERcast
At Hippo, we make choices big and small based on our mission: to empower the people of medicine to learn, grow, and thrive through education and community. As emergency medicine and EM education continue to evolve, we’ve been asking ourselves some important questions:
Thrombolytics for the Coding Patient
Managing a cardiac arrest is the paramount skill of an emergency medicine physician. The process is a furious loop of assessments, actions, and decisions. Choices are often made with minimal information to fall back on, and delays of mere seconds can define the outcome. When running the rapid mental checklist of Hs and Ts, the decision to give or withhold thrombolytics is one that is often made amidst a fog of uncertainty. And while the...
Ultrasound in Resuscitation: What Every EM Clinician Should Know
Bedside ultrasound has become a common tool in many EDs. Potentially one of the most important uses of ultrasound is during resuscitation. When a patient is crashing and every moment counts, having the ability to quickly assess the clinical situation and make critical decisions is paramount.
Rethinking the Spinal Tap: The Paramedian Approach for Lumbar Puncture
It’s 2 a.m., and you’ve got a 28‑year‑old with signs of meningitis: fever, neck stiffness, altered mentation. You prep for the usual midline lumbar puncture, but the patient is obese, and you can’t clearly palpate the landmarks. The first stick goes bone‑deep, and there’s no CSF. Your frustration builds. The patient shifts; you adjust, but there is still no flow! What are you going to do next?
Asymptomatic Hypertension ACEP Clinical Guidelines Updates
“My dermatologist sent me to the ER for my blood pressure, and they told me I’m going to have a stroke.”
Managing Opioid Overdose: A Practical Guide for Clinicians
Opioid overdoses have become an unavoidable part of our daily shifts in the ED. It is a tragic commonality that transcends social and economic lines. It would be a safe bet that if you are reading this, you likely have a friend, family member, or colleague whose life has been disrupted by opioid abuse.