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ERcast Lite

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

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Jan 2, 2017

What were your practice changers in 2016? For me, it was Reuben Strayer's simple phrase for when to give epinephrine in allergic reaction patients: For A, B, or C,  give E. If there is involvement of airway, breathing ,or circulation, give epi. It seems simple when it's spelled out this way, but there can be a lot of hemming and hawing when deciding to give (or not to give) this drug. The other, less clinical, pearl is something learned from former Google engineer Chade-Meng Tang: pick two random people and think, "I hope that person is happy." That's it, just think it, don't have to do anything else. The results are astounding. Now let's hear what our guest panel has to say about what changed their practices in 2016....


Simon Carley @EMManchester


Michelle Lin @M_Lin


Lauren Westafer @LWestafer

  • Elevates the head of the bed to 30-45 degrees when intubating


Jeremy Faust @jeremyfaust

  • Recommends E-Cigs as an option for patients trying to quit smoking


Jess Mason @Jessmasonmd


Al Sacchetti @Sacchettialfred

  • Use ultrasound to confirm foley catheter placement


Adam Rowh

  • PATCH Trial
  • Richard Feynman “So my antagonist said, "Is it impossible that there are flying saucers? Can you prove that it's impossible?" "No", I said, "I can't prove it's impossible. It's just very unlikely". At that he said, "You are very unscientific. If you can't prove it impossible then how can you say that it's unlikely?" But that is the way that is scientific. It is scientific only to say what is more likely and what less likely, and not to be proving all the time the possible and impossible.”


Anand Swaminathan @EMSwami

  • Azithro is losing potency against Strep Pneumo
  • The EKG findings in PE
  • Pre-charge the defibrillator during CPR
  • Use the pelvic binder properly
  • Use the oxygen wave form to confirm pacemaker capture
  • Shared decision making


Scott Weingart @emcrit

  • Be careful with hyponatremic patients