You’re working in a busy suburban ED when a patient presents with an abscess of the forearm that’s been growing for three days. The patient denies any IV drug use, significant comorbidities, or prior abscesses. You determine that the patient has an uncomplicated (no overlying cellulitis) 4cm abscess that would benefit from I&D, which is completed with irrigation and gauze packing. The patient asks you if you think they need antibiotics…
In the ED, NS is the solution of choice for cleaning wounds. It’s sterile, isotonic, innocuous, readily available and, as far as any of us knows, probably relatively inexpensive.
Test Your Knowledge Which of the following maneuvers decreases post-LP headaches?
B. Reduced number of attempts
C. Smaller gauge atraumatic needles
D. IV fluids
E. Patient positioning
F. Clinician experience
G. All of the above
Corticosteroids, Antivirals, Both or Neither?
I was recently questioned by one of our residents as to whether there is sound evidence that crystalloids were better than colloid solutions in trauma resuscitation. I said, “yes, of course.”
Should this patient with a TIA be admitted for work-up or can they be safely sent home?
Knowledge translation is the science of moving evidence to action. If EPs continue to lag behind in adopting evidence-based best practices, special interests will do it for us.
Abnormal ECGs in the morbidly obese
Can you spot the obesity-related normal ECG variants?
Should US physicians use the Canadian head CT rule?
Are the standards of care in Canada and the U.S. different with regard to ordering CT scans for minor head trauma? Does practicing defensive medicine ignore evidence-based best practice or is it just our American reality.
Spare your next patient the discomfort of the DRE unless there is obvious indication.