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the County Consult

A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.

Figure 1. Study design and outcomes.

The Cheese - Small vs Large Bore Thoracostomy Tubes

December 20, 2024

Tube thoracostomy is generally the recommended treatment for a traumatic hemothorax. However, there is no consensus on optimal catheter size.  In recent years, there has been a move from using small bore tube thoracostomy (SBTT) for pneumothorax. SBTT provide increased patient comfort and seem to be equally as effective for pneumothorax. That said, what does the literature say about SBTT for hemothorax?

Kathryn McGregor, MD; Taylor Wahrenbrock, MD; Eric Leser, MD; and William Brigode, MD

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In Trauma
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Figure 1. Index ECG.

The Heart of the Matter - A Case of Chest Pain

December 13, 2024

A 50-year-old male with past medical history of hypertension, hyperlipidemia, type 2 diabetes mellitus, and alcohol use disorder presents to the ED with chest pain. He states that his chest pain started around 6:30 PM today (it is currently 9:10 PM) and that he felt dizzy and diaphoretic upon onset of symptoms. He denies fever, chills, SOB, abdominal pain, nausea, vomiting, change in bowel habits, dysuria or any other complaints. An ECG was obtained on arrival (Figure 1).

Authored by Michael Hohl, MD; Taylor Wahrenbrock, MD; and Ari Edelheit, MD.

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In Cardiology
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Figure 1. SQuID Protocol vs. IV Infusion DKA Protocol (Griffey RT, et al.).

The Cheese - Subcutaneous Insulin in DKA

December 6, 2024

Article Reviewed:

Griffey RT, et al. The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. Acad Emerg Med 2023. PMID: 36775281

Authored by Taylor Wahrenbrock, MD, Kathryn McGregor, MD, and Eric Leser, MD.

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