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Diagnostics, Intern Radiology Videos Jeffery Hill, MD M.Ed Diagnostics, Intern Radiology Videos Jeffery Hill, MD M.Ed

The Approach to Shoulder Radiographs

The first snowflakes of the year are falling as you head into your midday Minor Care shift.  Slipping on an icy patch of compacted snow and nearly falling as you head from your car to the ED entrance, you have a sneaking suspicion what the day will bring: falls, slips, and trips.  Indeed, you settle down to the computer, log in to your EMR and pull up the minor care screen to see 2 unseen patients with the chief complaint of “Fall”...

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Diagnostics, Grand Rounds Timothy Murphy, MD Diagnostics, Grand Rounds Timothy Murphy, MD

CSF Evaluation in Subarachnoid Hemorrhage

So, what constitutes a “positive” tap when evaluating for subarachnoid hemorrhage?

Traditional teaching is that a positive tap is Xanthochromia or blood in the CSF

What exactly is Xanthochromia?

The word xanthochromia is simply Greek for “yellow color.”  It refers to the yellow color that CSF can take in certain situations.  Some of these situations are listed below:

  • Elevated CSF protein            
  • Jaundice
  • Hypervitaminosis A
  • Rifampin Therapy
  • Elevated Bilirubin
  • Oxyhemoglobin

What we are especially interested in when evaluating for subarachnoid hemorrhage is bilirubin and oxyhemoglobin.

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Diagnostics, Grand Rounds Jeffery Hill, MD M.Ed Diagnostics, Grand Rounds Jeffery Hill, MD M.Ed

Respiratory Monitoring - An Introduction to Pulse Ox and Capnography

First a bit of physics....

Both pulse oximetry and capnometry rely on the Beer-Lambert Law. 

  • In 1760, Johann Heinreich Lambert proved that the absorbance of light through a material is proportional to the thickness of the material.  
  • In 1852, August Beer proved that the absorbance of light through a material is proportional to the concentration of the attenuating substance in the material.
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