The Use of the Modified Valsalva Maneuver for Stable SVT

In Medical Concepts, Tiny Tips by Paula Sneath0 Comments

Please note that, while “supraventricular tachycardia (SVT)” is a term that can be used more broadly to refer to any tachyarrhythmia originating above the ventricles, I use its more conventional meaning here to describe AVnRT and AVRT. LITFL has a good summary of narrow-complex tachycardias. SVT is a narrow complex tachycardia commonly seen in the emergency department. In hemodynamically stable patients the first-line treatment is vagal stimulation, usually the Valsalva maneuver. However, success …

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Tiny Tips: “SNOOP MEETS Pregnancy” Headache mnemonic

In Medical Concepts, Tiny Tips by Sean Patrick0 Comments

Many must-not-miss diagnoses manifest as a secondary headache. Though the DDx list is quite large, the pertinent questions that must be asked on history can be remembered using the mnemonic “SNOOP MEETS Pregnancy”1,2 Below you’ll find the cues associated with each letter, the symptoms they are associated with, and the differential diagnosis for some of those symptoms. Systemic symptoms = fever, night sweats, weight loss, loss of appetite, protracted vomiting DDx: Meningitis, Encephalitis, Systemic infection, Lyme …

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Tiny Tip: Back Pain Differential Mnemonic

In Medical Concepts, Tiny Tips by Carly Rumley0 Comments

Back pain is a common presentation to the Emergency Department. It is associated with disability, health care expenses, and a loss of wages and productivity. When caring for a patient and developing a back pain differential diagnosis, remember to consider age, the history, physical exam findings, laboratory results, and imaging (if needed). Be sure to keep in mind the red flags for back pain that include: history of IV drug use, history of …

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Tiny Tip: SCALP for the Layers of the Scalp

In Medical Concepts, Tiny Tips by Sarah Luckett-Gatopoulos0 Comments

At some point during clinical teaching in emergency medicine, someone is likely to ask you about the layers of the scalp, and Rosen’s provides a helpful mnemonic for remembering them1: S – skin C – connective tissue A – aponeurosis L  – loose areolar tissue P  – periosteum You may be asking yourself why you would need to know about the layers of the scalp. Isn’t this just the sort of trivia you …

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Tiny Tips: How ready is this child?

In Medical Concepts, Tiny Tips by Sarah Luckett-Gatopoulos0 Comments

Not many neonates are delivered in the Emergency Department, but those rare babies who greet the world for the first time under the fluorescent lights of the resuscitation bay are precisely those who warrant urgent and concise communication about their clinical status to our obstetric, paediatric, and neonatologist colleagues. The Apgar score is an assessment tool designed for precisely this kind of communication. Developed by Virginia Apgar, an American obstetrical anaesthesiologist, the Apgar score …

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Tiny Tips: HEADACHe Red Flags Mnemonic

In Medical Concepts, Tiny Tips by Tetyana Maniuk0 Comments

Patients with complaints of acute headache comprise 4% of emergency department visits.1 Most headaches presenting to the ED are primary headaches such as migraines, however, important secondary causes, such as hemorrhage, cannot be missed.2. A recent CrackCast outlined an excellent approach to headache red flags. The HEADACHe mnemonic can help you remember these red flags3! History describing the worst headache of life or a headache that is different than usual Exertion as a trigger for …