The REVERT trial showed 43% success in converting hemodynamically stable SVT to NSR with modified valsalva as compared to 17% with standard valsalva. Free, simple, effective and less adenosine impending sense of doom! #FOAMed #FOAM4Cook rebelem.com/the-revert-tri…

Is it cellulitis or nec fasc? A LRINEC score > or = 6 has a PPV of 92% and NPV of 96% for nec fasc. #FOAMed #FOAM4Cook pubmed.ncbi.nlm.nih.gov/15241098/

Have a patient with hyperkalemia and ECG changes? Remember the management with the mnemonic C BIG K DROP: Calcium gluconate, bicarb or beta agonist, insulin, glucose, kayexalate, diuretic, dialysis. canadiem.org/tiny-tip-hyper… #FOAMed #FOAM4Cook

A quick story from Cook County EM: my intern year, I saw an older guy following an unintentional heroin overdose. We talked about how it was a particularly scary time to use opioids. Fentanyl analogues and heroin adulterants were driving a big spike in Chicago overdose deaths

Worried your patient is going into Rhabdo? Want some evidence based guidance? Use the McMahon score!pubmed.ncbi.nlm.nih.gov/24000014/ #FOAMed #FOAM4Cook

Syncope has historically been difficult for EM providers to evaluate, with most patients getting admitted for workup. The Canadian Syncope Risk Score has been newly validated and can help determine disposition for these patients. rebelem.com/validation-of-… #FOAMed #FOAM4Cook

On shift tonight Cook County EM saw a patient with a malfunctioning pacemaker presenting with symptomatic bradycardia. Permanent pacing is indicated for symptomatic mobitz II and third degree heart block. Great review of pacemakers: rebelem.com/pacemaker-basi… #FOAMed #FOAM4Cook

Be careful when rate controlling a pt in a-fib with RVR who has underlying sepsis or another reason they are tachy. If you drop their HR, their CO will plummet. Is the a-fib the primary concern or is there an underlying process? thelancet.com/journals/lance… #FOAMed #FOAM4Cook

Don't stop at one salicylate level. Trend Q2-4 hr and if it goes up consider giving activated charcoal - your aspirin overdose pt may still be actively absorbing. Review of salicylate tox: rebelem.com/salicylate-tox… #FOAMed #FOAM4Cook

Euglycemic DKA is associated with the use of SGLT-2 inhibitors. If your diabetic patient on these meds presents with nausea/vomiting/fatigue, be sure to check for metabolic acidosis and ketones! rebelem.com/euglycemic-dka… #FOAMed #FOAM4Cook

AVM can be a scary cause of stroke in a young otherwise healthy patient. Although the prevalence is low (.14%), the risk of bleeding is 2-4% per year. Angiography is the gold standard for evaluation, with MR > CT. wikem.org/wiki/Arteriove… #FOAMed #FOAM4Cook

Getting an initial US instead of CT for suspected nephrolithiasis can reduce overall cumulative radiation with no significant difference in patient outcomes including complication, pain, return visit, and hospitalization rates: nejm.org/doi/full/10.10… #FOAMed #FOAM4Cook

A Lisfranc injury to the tarso-metatorso articulation will require eventual surgery. However, up to 20% of these are missed in the ED. Many do not meet Ottawa ankle criteria, so have a low threshold to image if suspected. emdocs.net/core-em-lisfra… #FOAMed #FOAM4Cook

Have a young otherwise healthy patient who presents with syncope but now feels great and wants to go home? Keep an eye out on EKG for Brugada sign. Review of the different Brugada syndrome types: litfl.com/what-is-brugad… #FOAMed #FOAM4Cook

This month, the 90 day outcomes of the CODA trial were published. The authors conducted a non-inferiority RCT comparing antibiotics to appendectomy for appendicitis. Great data to show patients during shared decision making! #FOAMed nejm.org/doi/full/10.10…

Introducing Harbor-UCLA Emergency Medicine Class of 2025!! We are beyond excited and lucky to have recruited such outstanding people who will serve our wonderful patients in the County of Los Angeles! #WhyHarborEM #HarborLove #ThisIsHarbor @DrPedigo MprizzleER Cindy Chang, MD MEd Joyce Wahba Jon Warren, MD

Excited and honored to be coming home and to serve the County of LA for the next 4 years!

🎉 Meet Aaron Katrikh, MD - Recipient of the EMRA/ACEP EDDA Travel Scholarship Award for 2023! Aaron received this award for his dedication to emergency medicine and leadership skills. Congratulations, Aaron Katrikh, MD! Harbor-UCLA Emergency Medicine

Emergency medicine is a lifestyle, not just a job. You’ll see the sickest patients, the worst luck, and the darkest corners of humanity—& still be expected to smile, move fast, and get it right every time. A thread on what they don’t tell you about EM. 🧵