EMTALA for Dummies
What is EMTALA? EMTALA stands for “Emergency Medical Treatment & Labor Act.” It is a federal law enacted by Congress in 1986 to prevent hospitals from sending away patients based on insurance...
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Fireworks: Facts vs Fiction
On account of the holidays, we’re starting July off with a bang with a Triple Pearl. There is a significant increase in firework-related injuries this time of year, but the distribution of injuries may...
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Safe Discharge for Undifferentiated Abdominal Pain
Abdominal pain is the most common chief complaint in the emergency room, yet up to 40% of these patients are discharged without a definitive diagnosis. In cases of nonspecific abdominal pain, it is...
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The K2 Chameleon
This Tuesday, the New York Times reported that 33 patients from the same Brooklyn neighborhood were transported to the ED due to a “bad batch” of K2. But what is a “bad batch,” and what does it mean in...
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Glucagon for Beta Blocker Overdose
When Should I Use It? For cases of profound beta blocker overdose with clinically significant cardiovascular depression (symptomatic bradycardia, hemodynamic instability). Since many patients are on...
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Staying Cool: An Overview of Therapeutic Hypothermia
If you’ve ever been confused about why cooling matters in post-cardiac arrest, when to do it, how to order it, or what temperature (34C? 36C?) is best, read on. Why do we do this? To protect the brain...
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How a Chest Tube Drainage System Works
If you’re like me, you probably hook your chest tube up to a Pleur-Evac, put it on the ground, then back away slowly. Who knows what goes on in that mysterious bubbling white box? Hopefully this will...
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Elevated Lactate: Significance and Challenges
Given the evolving definition of sepsis and the continual push to report sepsis measures to State Health Departments and CMS, I thought the time is ripe to revisit a popular topic: the significance of...
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Single Troponin for Atypical Symptoms? – PART I
You’re working in Geri and have 10 elderly patients with dizziness and/or SOB on your board. None of them can reliably recall when their symptoms started. You are about to order “just one trop” on all...
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Single Troponin for Atypical Symptoms? – PART II
This is part two of a three-part series to answer the question, “it is acceptable to order a single troponin in an elderly patient with dizziness, weakness, or a similarly vague anginal equivalent?” So...
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Serial Troponin for Atypical Symptoms? – PART III
Serial Troponin for Atypical Symptoms? – PART III In general, the literature suggests that elderly patients who present with atypical chest pain should receive at least two troponins for several...
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