Facial nerve blocks can provide good anesthesia to various regions of the face. This came in handy for my patient with a lower lip laceration. Knowing where to inject the lidocaine is just about remembering your anatomy!

Broselow Peds Emergency Tape came in clutch in my first Peds ED sim yesterday. Had no idea about measuring the baby’s height to calculate weight, various med dosing, and equipment size. Btw there’s also a nice lil equation for peds ETT size: (age/4) + 4

An oldie but a goodie: the H’s and T’s. These are the reversible causes of cardiac arrest that are quickly considered during any code situation

Enjoyed the view of Dallas from the Parkland helipad yesterday on my EM away rotation Sub-I orientation at UTSW. Excited to be here for the month! #UTSWem

if you have a pt coming in with a clonidine OD and nothing seems to be working, try Narcan. there seems to be mixed data as to its effect, but clonidine may directly or indirectly stimulate the mu receptor. if you use it, you might need higher doses than you might think. #cincyai.

Breaking bad news to patients is difficult. Put yourself in the patient’s shoes and think about how you might react - your brain going off in a million directions trying to process it. Similarly, patients may want the space to process before you explain what happens next #cincyai.

Hematuria has a sensitivity of 71-95% for kidney stones. However, in the end, we are here to treat the pt, not just the numbers. So if you are still suspecting a stone despite a normal UA, you may still want that CT, since hematuria can be absent in obstructive stones. #CincyAI.

Recognizing toxidromes is important in the ED. Cholinergic is the classic DUMBBELSS (parasympathetic). Sympathomimetic is all the uppers. Anticholinergic is similar to sympathomimetic but is dry. Opioid's classic triad of miosis, respiratory depression, and coma. #CincyAI

learning how to use the ultrasound, moving/fanning the probe all over until you see something, feels a little like playing a video game, clicking random buttons until you win😂.this diagram nicely demonstrates probe placement, anatomy, and ultrasound images for an echo #CincyAI

Lac repair tidbits: .- lido w/ epi is typically avoided in ears, nose, fingers, and genitals.- fast gut sutures absorb in 5-7 days.- nylon is a common non-absorbable suture.- 4-0 is a commonly used suture size. 5-0 for delicate areas.- don't forget to ask about tetanus!.#CincyAI.

Globe rupture is the one time you do NOT want to use tonometry, as the additional pressure will cause more damage. However, using fluorescein, you will see a positive Seidel’s test, which is leaking of aqueous humor from the anterior chamber. Call Ophtho right away! #CincyAI

in seizures that are refractory to the usual treatments (benzos, fosphenytoin, keppra, etc.), consider isoniazid toxicity causing pyridoxine (vit B6) deficiency. Metabolic acidosis w/ elevated lactate + refractory seizures + coma = INH toxicity. #CincyAI

Necrotizing fasciitis is an emergency! It requires urgent surgery & complex treatment w/ Vanc, Zosyn, and Clinda to cover for gram positives & negatives and anaerobes. Clinda specifically has been found to decrease clostridial toxin production. #CincyAI.

Medication route of administration may affect where ED pts can be admitted, as many IV drips require pts to go to the ICU. Some meds only come as drips such as nicardipine. Others such as insulin, dilt, pressors, and sedatives have various forms, one being an IV drip. #CincyAI.

Focusing the slit lamp correctly isn't always easy, but an important sign to keep your 👁️ out for is "cell and flare", often seen in uveitis. The speckles are individual inflammatory cells, and flare is the foggy appearance due to protein leakage from blood vessels. #CincyAI

I didn't know about PRES syndrome until last night. It consists of seizures, headache, vision changes, and AMS, and is often associated w/ acute HTN, kidney dz, eclampsia, and immunosuppressive meds. Definitive diagnosis is vasogenic edema on MRI #CincyAI.

My patient's EKG with Afib plus PVCs looked wonky to my medical student eyes. But have no fear, PVCs don't always mean a call to the cardiologist - they can often be a normal variant. PVCs can have various morphologies, but the wide QRS should give it away. #cincyai