The Precordial Thump: G...

It’s one of those mythical interventions that everyone has heard of, less have attempted and few have seen used successfully. Everyone knows someone who knows someone that brought a patient back from the brink using only hope and the power contained within a tightly clenched fist....

Diagnostic Statistics f...

A few weeks ago I was tweeting about the excellent Statistics in Medicine MOOC offered by Kristin Sainani of Stanford University when Ernesto asked: @BoringEM how do you find this as a resident? Is statistics a gap in your training? #justcurious — Ernesto (@DilettanteMD) July 22,...

ID Badges: You’re...

In every hospital I have ever worked at I have been confused about who was who at one point or another. Although it hasn’t always been verbalized, I’ve mistaken ward clerks, nurses, nursing students, medical students, residents, respiratory therapists, pharmacists, physical...

D-Dimer: Should we adju...

Recently this article flew across my twitter feed via a link from Cliff Reid: Diagnostic accuracy of conventional or age adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism: systematic review and meta-analysis (open access BMJ June...

Handheld Ultrasound ...

As it seems to be ultrasound month on BoringEM (see the guest posts from Paul Olszynski here: A Pictorial Approach to Ultrasound in Shock and Chris Byrne here: Point of Care Ultrasound: A Hyperechoic Future in Med Ed), I thought I’d chime in with a review of my new toy. I...

A Pictorial Approach to...

I just finished preparing an introductory talk on shock & ultrasound. Ultrasound in shock in 50 minutes! After having struggled considerably with the breadth of the topic, i struggled even more with the summary. How does one sum up such a huge topic? In the end, I decided to go with a...

The Agitated Patient in...

In my first post of a trilogy on the agitated patient in the ED I outlined BARS sedation score for defining levels of agitation, discussed how to risk stratify a potentially agitated patient and offered some tips on how to deal with the mildly agitated patient. This post will discuss...

The Agitated Patient in...

When the topic of agitated patients in the ED is brought up, most people conjure up an image of a psychotic manic patient or tell the story of a patient brought in after ingesting a combination of methamphetamine and bath salts. Acutely agitated patients like this are a danger to...