A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
Figure 1. The four order set pathways for opioid and xylazine withdrawal. Based on severity of withdrawal, ability to gain IV access, and known or concern for prolonged QTc.
EMS brings in a patient who is reporting heroin withdrawal, so you reflexively give the patient an IV fluid bolus and Zofran, but he is now feeling worse. You try sublingual buprenorphine 8mg, and while the patient initially feels better, he is feeling even sicker a few hours later. What else may be going on? What other options are at your disposal to improve your patient’s symptoms?
Taylor Wahrenbrock, MD; Kathryn McGregor, MD; Eric Leser, MD; Michael Nelson, MD; Antonia Nemanich, MD
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Figure 1. Index ECG.
A 48-year-old male with a past medical history of SVT, atrial flutter/fibrillation, hypertension, and hyperlipidemia presents to the ED with chest pain, shortness of breath, and palpitations that started 3 hours prior to arrival. His symptoms started suddenly. He has been compliant with all of his home medications. An index ECG above was obtained in triage.
Megan Buranosky, MD
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Figure 1. Study design and outcomes.
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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