Emergency Tips

Myocarditis should be considered in a patient with a sustained, unexplained tachycardia

The concomitant ingestion of ethanol (ETOH) with methanol or ethylene glycol protects against toxic metabolites

Consider a retropharyngeal space infection in a young child presenting with a history of fever, refusal to drink, sore throat, and reluctance to move their neck

In patients with hyponatremia, to avoid central pontine myelinolysis, serum sodium should never be raised by more than 0.5 mEq/hr or 12 mEq in 24 hours.

In almost all cases, trauma patients with unstable vital signs and a positive ED-focused abdominal sonography for trauma (FAST) examination for free fluid should go directly to laparotomy

The patient with a posterior nasal packing in place must be monitored in the hospital for recognition of hypoxia or apnea secondary to stimulation of the nasopulmonary reflex

CT of the head will identify 95% of patients with subarachnoid hemorrhage. Lumbar puncture (LP) is recommended for patients with a strong clinical suspicion, despite a negative CT of the head

Emergency medicine, by its nature, has more failure-producing conditions than any other specialty in medicine

The problem of “error” in medicine, and the adverse events that sometimes follow, are problems of psychology and engineering, not of medicine

A D-dimer assay is only useful to exclude thromboembolic disease in patients with a low pretest probability

Determination of pretest probability for venous thromboembolism (VTE) is critical in knowing when to initiate a diagnostic work-up and how to interpret your test results.

A contaminated wound is one with a high degree of bacterial inoculum at the time of injury and not synonymous with a dirty wound

Examine every patient with urticaria for mucosal edema, stridor, wheezing, and hypotension to rule out life threats associated with anaphylaxis

IV bolus administration of epinephrine to a patient with an obtainable BP and pulse can result in ischemic cardiac pain, hypertension, supraventricular tachycardia (SVT), and VT

Any elderly patient with flank, back, abdominal pain, hypotension, syncope, or pulseless electrical activity (PEA) should have an emergency ultrasound examination to evaluate for an AAA

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