Clik here to view.
Imaging in Blunt Trauma, Questions
1. How do you decide which patients with abdominal trauma need a CT? 2. Do you order chest CTs on stable patients with focal chest wall tenderness and a normal AP chest X-ray? 3. Do you pan scan in...
View ArticleClik here to view.
Imaging in Blunt Trauma, “Answers”
1. How do you decide which patients with abdominal trauma need a CT? Setting aside those patients with obvious abdominal injuries, for whom most every Emergency Physician would order an abdominal...
View ArticleClik here to view.
Burns, Questions
1. When (if ever) do you open blisters in acute burns? 2. When do you transfer patients directly to a burn center versus outpatient follow up? How do you arrange that follow up and for when? 3. What...
View ArticleClik here to view.
Burns, “Answers”
The traditional classification of burns as first, second or third degree is being replaced by the designations of superficial, superficial partial thickness, deep partial thickness, and full thickness....
View ArticleClik here to view.
Pulmonary Embolism, Questions
1. Which decision rule(s) do you use to determine if a patient is low or very low risk for PE? 2. Are there any situations in which you modify the d-dimer threshold for ruling out PE? If so, when? 3....
View ArticleClik here to view.
Pulmonary Embolism, “Answers”
1. What decision rules do you use to determine if a patient is low or very low risk for PE? The most commonly used decision instruments for risk stratification are the Wells’ score, Geneva score, and...
View ArticleClik here to view.
Pneumothorax, Questions
1. What is your first line imaging test to diagnose pneumothorax (PTX)? When do you get a CT? 2. How do you manage traumatic pneumothoraces found incidentally on CT (i.e., not clinically apparent, not...
View ArticleClik here to view.
Pneumothorax, “Answers”
1. How good is CXR for detection of a pneumothorax? Ultrasound? When do you get a chest CT in someone you suspect may have a pneumothorax but has a negative CXR? The sensitivity of a chest radiograph...
View ArticleClik here to view.
Troponin testing, Questions
1. Do you ever send a single troponin in patients with chest pain? If so, when? 2. How do you manage patients with end stage renal disease (ESRD) and chest pain who have equivocal troponins? 3. Do you...
View ArticleClik here to view.
Troponin testing, “Answers”
Troponin is a structural protein found in striated muscle and is involved in calcium processing. Although troponin can be found in many types of muscle, cardiac troponins are structurally different...
View ArticleClik here to view.
Questions, Fluid responsiveness
1. How do you assess fluid responsiveness in the ED? Do you use inferior vena cava (IVC) collapsibility in the spontaneously breathing? 2. Which crystalloid fluid do you use to resuscitate critically...
View ArticleClik here to view.
Fluid Responsiveness, “Answers”
1. How do you assess fluid responsiveness in the ED? Do you use IVC collapsibility in spontaneously breathing patients? Although fluid resuscitation is paramount in the treatment of sepsis, volume...
View ArticleClik here to view.
tPA in ischemic stroke, Questions
1. How do you control blood pressure in patients who will be/are receiving tPA? 2. Do you treat patients with tPA up to 4.5 hours from onset of symptoms, and if so which ones? 3. How do you determine...
View ArticleClik here to view.
tPA in ischemic stroke, “answers”
1. How do you control blood pressure (BP) in patients who will be or/are receiving tPA? For patients not receiving tPA for acute ischemic stroke, allowing autoregulation of blood pressure has long been...
View ArticleClik here to view.
Epistaxis, Questions
1. How do you differentiate an anterior from a posterior nosebleed? 2. What type of nasal packing do you prefer if direct pressure and silver nitrate cautery fail? Guaze ribbons? Nasal foam tampons...
View ArticleClik here to view.
Epistaxis, “Answers”
1. How do you differentiate an anterior from a posterior nosebleed? Whether you’re sitting high in the bleachers of a baseball game or treating a patient in the Emergency Department, nosebleeds can be...
View ArticleClik here to view.
Medicaton Comparisons, Questions
1. Acetaminophen vs. ibuprofen: Which do you prefer for analgesia? For fever reduction? 2. PPIs vs. H2 Blockers: Which is your first choice for GERD/gastritis? 3. Meclizine vs. benzodiazepenes: Which...
View ArticleClik here to view.
Medication Comparisons, “Answers”
1. Acetaminophen vs Ibuprofen. Which do you prefer for analgesia? For fever reduction? Pain and fever are among the most common chief complaints in the ED. Acetaminophen and ibuprofen are two of the...
View ArticleClik here to view.
Intracranial Hemorrhage, Questions
1. What immediate steps in management do you take when a patient with intracranial hemorrhage (ICH) exhibits signs of elevated intracranial pressure (ICP)? 2. In which patients with ICH do you push for...
View ArticleClik here to view.
Intracranial Hemorrhage, “Answers”
1. What immediate steps in management do you take when a patient with intracranial hemorrhage (ICH) exhibits signs of elevated intracranial pressure (ICP)? The immediate steps in the management of...
View Article
