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ERCAST

Welcome to ERCast, a focused discussion on the questions, quagmires and known unknowns we face everyday in the emergency department.

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Apr 17, 2018

A few weeks ago, a post on Clay Smith’s Journal Feedabout the new IDSA C diff guidelines caught my attention (specifically, that metronidazole is no longer recommended as first line therapy). Whuut? I tweeted this and @medquestioningtweeted back, "Need to dig to see why they dropped metro in the bucket." Yes,...


Mar 21, 2018

Walker Foland is an emergency physician practicing in Michigan and in this episode breaks down why pseudoseizures, now termed PNES (Psychogenic Nonepileptic Seizures), are a real disease.

 

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Are patients with PNES ‘faking it’?

  • PNES is a conversion disorder: an unconscious...


Mar 5, 2018

In the edition of the Ercast journal club

  • thrombectomy in pts with delayed stroke presentation shows promise
  • beware behavioral changes after procedural sedation
  • kids with isolated linear skull fractures have a good short term prognosis
  • procalcitonin may help decrease abx use in respiratory infections
  • steroids in mild...


Feb 5, 2018

Vicky Vella is an emergency physician practicing in the United Kingdom with a special interest and expertise in eating disorders. In December of last year, Vicky had a guest post on the St Emlyn’s blog about the MARSIPAN Guidelines. Never heard of them? Neither had pretty much anybody. MARSIPAN is an acronym for...


Jan 15, 2018

Should I give bicarbonate to DKA patients with severe acidemia? I've certainly been admonished for NOT doing it. The reason for withholding bicarb has been that I've heard that it doesn't help and may actually be a bad idea. I can't say the action (or inaction) was based on a deep understanding.

How could bicarb in DKA...