Tamingthesru
Diagnostics: Alternative EKG Leads
Ever have a patient that looks more concerning than their EKG? Perhaps their ischemia is in that anatomically difficult to access right ventricle or even posterior. Join Dr. Connelly in looking at the utility of right sided, posterior and Lewis leads and bring something new to your next chest pain patient.
The CBC and the Man Behind the Curtain
It’s been called “the refuge of the intellectually destitute (physician)” by Amal Muttu. The CBC is a much maligned test that is nevertheless one of the the most frequently ordered diagnostic tests in the ED. To truly know how to interpret this test, one must understand its individual components, the possible causes of variations from normal for those components, and how it integrates into the clinical presentation of the patient. Also, it can’t help but to know and understand some of the historical background…
The Importance of the RUG
It is early on in your residency training, when you receive sign-out of a patient who was involved in an MVC with multiple injuries including a stable pelvic injury. The patient, a middle-aged male, has not voided three hours into his visit and there is no mention of any obvious genital trauma. He has had a negative FAST exam in addition to the rest of your primary and secondary assessment. The patient mentions to the nurse that he is trying to urinate but cannot void and has some discomfort. The bladder scan shows that the patient has about 500cc of urine and when the nurse goes to place a urinary catheter she pauses as she sees what appears to be dried blood at the urethral opening. After reassessing the patient who is still hemodynamically stable with normal mentation, his findings are discussed with Urology who recommend getting a retrograde urethrogram prior to any additional procedures.