Calcium channel blockers consistently outperform adenosine for SVT, and do not make people feel like they're going to die. I haven't used adenosine for stable SVT in many years.

Adding this to my intubation checklist.

How I see patients in the emergency department, after 20 years of seeing patients in the emergency department.

It took 15 years, but the dirty epi drip is finally evidence-based. Aussies come through again.

RT @CanadianKayMD: This week’s @Radiolab is a great peek into the history of an important step in trauma management - the creation of ATLS….

Gold star to whoever conceived of this study.

Comprehensive discussion around the many emergency department uses of #ketamine .

happy holidays, everyone. and by holiday, I mean the 10 year anniversary of the Ketamine Brain Continuum.

Because the trajectory of alcohol withdrawal is so unpredictable, effective treatment hinges on frequent reassessments. This is traditionally done based on the CIWA-Ar score, which is long/cumbersome. Using a short and easy scale encourages best practice.

These patients have a very difficult problem that is very difficult to treat. I took a stab at introducing emergency docs to problem, if not some solutions, here:.

The expert view (from the amazing Jane Ballantyne):. The 2016 CDC guidelines never called for providers to cut off patients already dependent, and the 2022 revision mostly just stipulates this more forcefully.

The fact that this piece misses, and that many patients with chronic pain (not to mention their prescribers) do not understand, is that in many if not most cases of severe chronic pain, the chronic pain arises not despite long term opioid use but *because of* long term opioid use.

I'm getting lots of messages about this NYT video.

unearthed a doctor bag I haven't seen for many years. I can't decide whether I miss carrying this stuff around or not. calculator still works somehow

Fantastic hyperthermia protocol buried in the letters of this month's Annals. Best practice translated to logistics-heavy, granular detail broken down by role and localized to department specifics. Bravo @bfeiny et al.

Complete airway obstruction by food bolus. Attempted removal with Magill forceps under VL visualization unsuccessful, so paramedic pushed the bolus aside to get an indirect view of the cords, which was navigated with a bougie. Damn fine work. #bougie.

EM expanded its scope to confront a new opioid addiction crisis, but we've done little to address alcoholism, despite always having front row seats to the saddest show on earth. Here is the first comprehensive guidance on the emergency management of AUD.

hey @reicherteye, maybe when the pressure is unreadably high, instead of "ERR" display ">60" or something. ERR on the side of not confusing clinicians, possibly delaying treatment of a vision-threatening diagnosis.

5 days post cataract surgery, chief complaint was periorbital headache. Tonopen gave me an error, I assumed like most ED equipment it was broken. No. this error means unreadably high pressure. Check the other eye: normal pressure. IOP > 60 on fancy ophtho machine.

A DATA-Waiver registration is no longer required to treat patients with buprenorphine for opioid use disorder. We've successfully X'd the X. Have a low threshold to administer and prescribe bup for OUD.