Emergency Medicine blog
Clinical teaching and practical ideas for your next study session.
Open-Fracture Antibiotics: Answer the SAQ Without Guessing the Grade
A strong open-fracture SAQ does more than list cefazolin, gentamicin, and penicillin. Separate immediate prophylaxis from a provisional injury grade, define the contamination risk, and name the protocol behind broader coverage.
Massive Hematemesis in the ED: When to Intubate—and When Not To
In massive upper GI bleeding, the airway decision turns on active emesis, the patient’s ability to clear blood, and mental-status trajectory—not simply the plan for endoscopy.
Pericardiotomy Incision: Get the Direction and Nerve Relation Right
A board-ready pericardiotomy answer needs two coordinates: a longitudinal cut placed anterior to the phrenic nerve. Learn to recall both without conflating direction and location.
US Navy Treatment Table 6: Depth, Oxygen, and Timing
When recompression is indicated for decompression illness, the standard U.S. Navy Treatment Table 6 starts at 60 fsw (2.8 ATA), uses timed oxygen periods and air breaks, then ascends in stages. Learn how to read the schedule—and what the 4-hour-45-minute figure includes.
Aortic Dissection With a Changing Pulse Exam: Recognizing Malperfusion
A pulse deficit that fluctuates can be an evolving warning, not reassurance. Learn how serial neurovascular findings guide recognition of possible branch-vessel malperfusion, the CTA question, and urgent escalation—without guessing the exact artery from one bedside exam.
Septic Obstructing Stone: First-Hour Plan Beyond “Call Urology”
The mark-bearing move in an infected obstructing-stone SAQ is to name urgent drainage—not stop at “consult urology.” Learn how to start antibiotics and shock care while arranging a stent or nephrostomy, and why definitive stone removal waits.
Pediatric Hemorrhagic Shock: When 10 mL/kg PRBC Is Not Enough
In a child with suspected traumatic hemorrhage, 10 mL/kg of packed red blood cells may be a reasonable initial dose—but ongoing bleeding may call for a pediatric massive-transfusion pathway, not repeated RBC-only boluses.
Smoke-Inhalation Intubation: Which Three Findings Matter?
For inhalation-injury SAQs, distinguish evolving airway compromise from evidence of smoke exposure. Three defensible findings—and a focused retrieval drill—make the answer clearer.
Pregnancy and Carbon Monoxide Poisoning: Why a Maternal COHb of 12% Isn’t Reassuring
A maternal COHb of 12% is not a fetal COHb measurement. Learn why pregnancy changes how the result should be interpreted, what fetal assessment can show, and why an early hyperbaric consultation matters.
COPD Exacerbation Oxygen: Treat 84% Without Chasing 100%
How should the ED correct hypoxemia in hypercapnic COPD without withholding oxygen or over-oxygenating? Use an initial controlled target, read the blood gas, and reassess ventilation separately.
Erythromycin Before Endoscopy: A Better View, Not Hemostasis
When a board stem asks which medication can improve the endoscopic view before upper endoscopy, the answer is IV erythromycin. The key distinction: better visualization is the goal; bleeding control still requires resuscitation and definitive hemostasis.
High LAMS, Low Certainty: Turning Motor Deficits Into an LVO Hypothesis
A high LAMS raises concern for proximal anterior-circulation ischemia, but motor severity alone cannot distinguish LVO from lacunar stroke, hemorrhage, or mimic. Learn the exam clues that convert a screening score into an ED imaging and triage decision.