Articles by Stuart P. Swadron, MD
This is the second installment of a piece based on an interview by Dr.
Rob Orman with Dr. Megan Cavanaugh, a colorectal surgeon in Portland,
Oregon. Although many of Dr. Cavanaugh’s recommendations are not based
on controlled trials, listeners nonetheless found the interview very
helpful. Her advice is straightforward and practical, with a good
measure of humor mixed in.
Many of us are a little tentative when dealing with emergency
presentations of ano-rectal disorders. A couple of months ago, we
featured an interview by Dr. Rob Orman with Dr. Megan Cavanaugh, a
colorectal surgeon in Portland, Oregon. The interview was surprisingly
popular because Dr. Cavanaugh was a great sport and didn’t hesitate to
weigh in candidly on our most common concerns.
A couple months ago on EM:RAP, Mel and I had a discussion about delirium tremens (DT). We see a lot of patients in our emergency department with this most severe form of alcohol withdrawal. On some shifts it seems as common for us at L.A. County/USC as STEMI or appendicitis. In order to qualify for this diagnosis, patients must have...
Not all of us work in busy trauma centers. And even for those of us who
do, it can sometimes be confusing to manage suspected vascular trauma of
the extremities. In last month’s EM:RAP, Mel interviewed our favorite
trauma surgeon, Dr. Kenji Inaba, who has a real knack for breaking
things down in a clear, straightforward way.
This is the third installment in a series focusing on the common
overdoses that cause bradycardia, hypotension and altered mental status.
Over the past several months during interviews with toxicologist Dr.
Sean Nordt, we have discussed calcium channel blockers, beta blockers,
clonidine and digitalis glycosides. All four classes of drugs can be
fatal in overdose and all of them appear on the list of single tablets
that can kill a child.
Overdoses that cause bradycardia and hypotension
Over the past several months, we have featured a series of interviews
with our resident toxicologist, Dr. Sean Nordt, on the common overdoses
that cause bradycardia and hypotension:
Recently on the EM:RAP podcast, we discussed the common presenting
complaint of visual floaters and flashes. Our discussion was prompted by
a recent piece in the JAMA Rational Clinical Examination series.(1)
This is a great series of articles that examines the diagnostic utility
of various clinical findings when considering important diagnoses in the
setting of common presenting complaints.
You just sent someone home with peripheral vertigo . . . or was that a stroke? Before
we break down an approach to vertigo, let’s briefly consider two
questions: just how often does this “nightmare” scenario occur and does
it really matter anyway?
In last month’s essay we discussed barotrauma, which occurs when gas in
the body’s air-filled spaces shrinks with descent and expands with
ascent. Perhaps the most common example of this is the diver that has
trouble equalizing the pressure between their middle ear and the outside
world due to a blocked or inflamed eustachian tube.
Dr. LoPresti has a knack for making sense of thyroid emergencies.
You’ll remember from last month that he used the term “decompensated
hypothyroidism” instead of myxedema coma. He explained that patients
who are hypothyroid, and thus have a decreased metabolic rate, conserve
heat by being in a constant state of vasoconstriction. That is why they
feel cool to the touch....
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