Why does my patient need to be flat?
With a recent N of 2, and with conversations about airway management, the RAMP position, and “defending physiology” ringing in my ears, I now have a new question: “I need to do a neck line. Does my patient need to be flat?” N of 1: Bad COPD, PNA, sick, no IV access. The pt. has bilat inguinal […]
THE Rules
Apologies to the Fat Man and the Velominati: We are the keepers of the house of medicine. Others have fallen by the wayside, but we are the salaried employees with no skin in the game, slaves to the shift schedule, acolytes of the Suk school, Sisyphean laborers who take care of anyone, for anything, at […]
Hypertensive Emergucation – Part II
To continue on the ranty but too lengthy exposition of IV blood pressure lowering… Where else does hypertensive emergency get invoked, in my opinion, inappropriately? Let’s continue and go through our top 4 sources of end organ damage so we can see what therapies are indicated: Heart! In association with angina and ACS, the […]
Hypertensive Emergucation – Part I
Overhead: “Level 1 triage coming in to Trauma-B” Me: “Who’s in triage? What are they sending?” Charge RN: “It’s a tachycardic emergency.” Me: “Um, but what is it? What are they here for?” Charge RN: “I just told you! HR was 146. EMS gave Lopressor x 2 with no relief.” Me: “…” (head explodes- triaged as […]
