EM Physician, PGY-1 | Opinions are my own
Joined September 2020
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A quick and dirty way to remember suture sizes: 3 things get 3-0: chest, abdomen, back. You have 4 limbs: extremities= 4-0. Your hand has 5 digits: fingers/hand= 5-0. Your face is Sensitive (Six)= 6-0. #CincyAI
Elizabeth Hellmann retweeted
I’m looking forward to seeing what Dabo answer is when they ask him if he still think @OhioStateFB is the 11th best team in the country.
Elizabeth Hellmann retweeted
This is a special community! The stethoscoop, revived by Dr Michael Hellman (@EMHellmann get him on Twitter!), is a weekly treasure of gratitude. ❤️ #UCtheLove #UCGratitude
Each week our chief residents send out a weekly newsletter, The Stethoscoop! There was so much love in this week's 'Scoop, we just had to share it with you.
Check out all of those Shoutouts! #UCtheLove
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Remember naloxone is a direct opioid receptor antagonist and may precipitate acute opioid withdrawal in chronic users, causing agitation and combativeness. Ideal dosages reverse respiratory depression without causing full withdrawal. #CincyAI
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Many patients who achieve ROSC after cardiac arrest suffer from anoxic brain injuries. Initiation of targeted temperature management (TTM) (cooling to 32-36C) may lead to improved functional recovery at hospital discharge. #CincyAI
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Broadly speaking, the most essential components for treatment of sepsis include: broad spectrum antibiotics, IV Lactated Ringers infusion at 30mL/kg, and vasopressors for persistent hypotension refractory to fluid resuscitation. #CincyAI
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The qSOFA score is a good tool to use in the ED to aid in determining outcome for septic patients. A positive score is at least 2/3 of the following: SBP < or = 100, RR > or = 22, GCS < 15. #CincyAI
Keep a wide differential for a patient coming in with odynophagia/dysphasia, including anaphylaxis, Ludwig angina, epigottitis, peritonsillar abscess, and cancer. These patients often have difficult airways to manage, so plan ahead in case of respiratory decompensation #CincyAI
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Elizabeth Hellmann retweeted
Check out this boss UC MICU team. Thank you all for your hard work! #UCthelove #UCgratitude
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There are many ways to reduce an anterior shoulder dislocation, including the Davos Method. This technique uses self-administered traction-countertraction, which allows the patient to control the forcefulness of the procedure, thereby minimizing pain and anxiety. #CincyAI
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Diagnosing acute MI can be difficult in patients with LBBB, whose EKG often shows “appropriate discordance” of the ST segments and T waves. This is where the Sgarbossa Criteria comes in, which looks for concordant ST elevation or depression to help identify infarction. #CincyAI
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Check out this link for a great explanation and example EKG’s! litfl.com/sgarbossa-criteria…
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Drug abuse can lead to exposure keratopathy, or corneal damage due to prolonged exposure to the outside environment. Smoked cocaine reduces the blink reflex by acting like a topical anesthetic. Similarly, elevated pain threshold due to amphetamines also reduces blinking #CincyAI
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You can diagnose this with your slit lamp exam in the ED! webeye.ophth.uiowa.edu/eyefo…
The onset of BZD withdrawal among chronic users can vary according to the half-life of the BZD involved. Symptoms may appear as early as 24 hrs or delayed up to 3 wks. Withdrawal sx’s are treated with a long acting BZD, which is gradually tapered over a period of months. #CincyAI
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A classic finding for PE on EKG is a deep S wave in lead I, Q wave in III, and inverted T wave in III. However this pattern is only found in about 20% of patients with PE and is neither sensitive nor specific. The most common abnormality seen is sinus tachycardia. #CincyAI
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In adults with severe asymptomatic hypertension (>180/>120), blood pressure should be reduced over a period of hours to days, to avoid complications like cerebral or myocardial ischemia. In general, MAP should not be lowered by more than 25% over the first several hours. #CincyAI
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One way to evaluate left ventricular contractility and ejection fraction with ultrasound is by measuring the E-point septal separation (EPSS). This is the distance between the anterior mitral valve leaflet and the interventricular septum during diastole. #CincyAI
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