Search results

The source of sepsis is typically the meningitis in these patients. Just isn't as common in the states (not sure where you practice, so my data my not be relevant to you) anymore as this cluster of symptoms sets off most physicians spidey-senses and the patient gets a tap and prompt broad...

I think you mean patients with meningococcal sepsis, isolated meningococcal meningitis (more common at diagnosis) carries a mortality of around 5% (pneumococcal is around 20%), vs sepsis which is around 30%, and were you will see the systemic effects you describe.

Most IV tubing sets are 20-30mL. To cause a clinically relevant air embolism would almost take the entire length of the tubing.

CT's won't show evidence of an acute ischemic CVA for several days. CTs in the acute phase are looking for blood.

My vote is a cerebellar stroke, or a complicated migraine. How exactly did the ED rule these out? If they did, then I guess its time to get weird. First zebra that popped in my head reading this was AIP, but I would find it strange if her first attack was at 44 years old.

The poster who said it was jwk, and if this is who I think it is, he/she is an AA. Etomidate has fallen out of favor with anesthesia because there are much, much better drugs to which they have access. Some of the reasons I see cited most are it causes myoclonus, adrenal suppression (often...

This cannot be repeated enough. I think ultrasound is both one of THE most useful imaging modalities and simultaneously one of the more difficult to become and stay proficient with.

Sure I'll be in the minority but I don't think it's a great idea. As pointed out already fairly steep learning curve and very user dependent, especially if you aren't doing it frequently. Plus I think it just provides one more excuse to stay on scene for too long.

There needs to be a thumbs up icon. . .

Yes, yes. We all know US docs are helpless/worthless without our beloved technology. My point was 3mm of deviation is nothing, that could be purely physiologic and normal. And I was unable to find any text that defined deviation as 3mm or greater (searched AccessMedicine, AccessSurgery...

Or one that cares about 3mm. . .

Not much to say in terms of EMS treatment. Treat it as any other form of diarrhea and provide supportive therapy.

I've never used serial 7's (nor have I seen any of the geriatricians/neurologists use it), I always have them spell world backwards. Way less thought involved on my part to make sure they are correct.

Insulin is not required for glucose transport across the blood-brain-barrier.

You can also see those deep symmetric t-wave inversions in head injury.

Would like to second this remark. My sentiments exactly.

Well that is the reality for a large number of departments/services. And I am in total agreement with Farmer2DO, not everyone with "10/10" pain is getting a narc, which is my only option pre-hospital, they will get assessed and treated based on both subjective and objective findings.

Medicine shouldn't be practiced in a manner where "the customer is always right." Turns out people actually don't always know what's best for them. Nice article illustrating that point from AIM this year: link to abstract And nice commentary on the article on the blog KevinMD: link

I agree with the sentiment but frankly giving a known abuser what they want isn't helping anyone.

Are you talking EMS or in hospital?