The use of intra-articular lidocaine for shoulder dislocation is a reasonable and evidence-based approach to facilitate shoulder reduction. This Clinical Question outlines the evidence to support its use and links to an excellent point-of-care video for outlining the procedure.
Medical Concept: Optic Neuritis
Optic neuritis is inflammation of the optic nerve. It typically presents with loss of vision, dyschromatopsia (color vision impairment) and ocular pain.
Boring Question: Fecal Leukocytes. Eh?
What are Fecal Leukocytes? Exactly what they sound like – white blood cells in liquefied poop. They can represent an inflammatory cause of diarrhea (acutely from infection or from an initial presentation of inflammatory bowel disease).
Boring Question: What is the role of the FAST exam for blunt abdominal trauma?
You are working an overnight shift in the emergency department when a 40 year-old male passenger involved in a high-speed motor vehicle collision arrives. His vital signs include a blood pressure of 88/56 mmHg, heart rate of 112, and respiratory rate of 16. His Glasgow coma score is 12 (3E, 4V, 5M). En route, your patient received 2L of normal saline with no change in his blood pressure. On exam, his abdomen is tender …
Boring Question: What is the role of xanthochromia in ruling out SAH?
The Case Your first patient of the shift is a 19-year-old male with “the worst headache ever.” His mother states she’s quite worried because he “never gets headaches.” He had some slight nuchal rigidity, but is afebrile. And as such, you arranged a non-contrast CT Head, which was found to have a normal without signs of intracranial hemorrhage. Now, 12 hours after onset of his headache, and after discussing the risk and benefits …
Boring Question: What is the risk of Contrast-Induced Nephropathy?
I once encountered a patient who was empirically started on warfarin therapy after a presumed diagnosis of pulmonary embolus. The treating team did not want to risk an AKI by performing a CT-PE as the patient’s creatinine was 120 and a V/Q scan was not an option due to underlying lung disease. This made me uncomfortable. There’s a known risk of hemorrhagic stroke (~0.5% per year) and other major bleeding events with warfarin, …