Class of 2007

What a fine looking cohort of folks. - wbl

Lecture: Seizures

Great lecture by Dr. Ray Regan on seizures in mp3 format. Download here or subscribe to our podcast to listen.

Seizures

-alex

... couple more from the retreat

Last Year's Retreat in ___ Baltimore

One of our yearly retreats... with some bystanders, including Harry Potter

Clonidine toxicity

I had an interesting case the other day: Young F on methadone presented with change in mental status, reported intake of 3 pills of clonidine.
VS: HR 35-40, BP 90/40, RR 11, POx normal, FS normal
PE: Depressed mental status but easily arousable by voice. However, pt's arousal was *very* transient. Mydriasis.
Our treatment: fluids, narcan (0.4), atropine (first 0.5, then 1mg), charcoal
ED course: pt became very agitated with the narcan, but hemodynamics did not improve until given the second dose of atropine and fluids.
What I learned: (From Ford: Clinical Toxicology, 1st ed)Clonidine toxicity can present similar to opioid toxicity : CNS depression, resp depression, miosis. Clonidine may also cause significant bradycardia and hypotension. The CNS depression from clonidine toxicity is unusual in that pts are easily arousable transiently (as soon as you stop stimulating them or talking to them, they can return quickly to a severely depressed MS); this can create problems if you try to intubate without full RSI meds, b/c they may wake up during the intubation. Also, pts may require significant amount of narcan (adults 1-2 mg / dose, up to 10mg). The rest of the treatment involves supportive care, atropine, charcoal, followed by dopamine if refractory bradycardia and/or hypotension.

-alex

Videos of ER procedures and splinting

"Emergency Medicine Education Online" has great videos of 1)Splinting 2) Life saving procedures like emergency thoracotomy, crich, central line placement...

EMEDU

ekg links

Some of my favorite articles on ekgs: (you can get the first 2 from MDConsult)

1. Additional electrocardiographic leads in the ED chest pain patient: right ventricular and posterior leads. Am J Emerg Med. 2003 Nov;21(7):563-73.
-(From our very own Amal Mattu)

2. Prominent R wave in lead V1: electrocardiographic differential diagnosis. Am J Emerg Med. 2001 Oct;19(6):504-13.
-(Again from Amal Mattu)

3. "Electrocardiographic Diagnosis of Acute Coronary Syndromes"

-alex

fun times...

dress code for the er...

holiday party pics

From our holiday party last winter... a good time was had by all.

intro

Welcome to the Thomas Jefferson Emergency Medicine Blog and Podcast site. Soon we will be hosting online audio podcasts of some of our weekly conference lectures for your enjoyment.

The Podcast will be hosted through the following feed: (cut paste this into iTunes [subscribe to podcast] or other podcast software)

http://feeds.feedburner.com/EML

Please email me at alex_mohseni@yahoo.com with any questions, comments or suggestions.

Please visit http://www.jefferson.edu/em/ to visit Jefferson's great Emergency Medicine program.

-Alex Mohseni (3rd year resident)