Excited delirium 1. Minimize patient exertion 2. Do not reduce minute ventilation 3. Provide early pharm restraint (ketamine best) #hcmca16

Deep crazy T-wave inversions w/ T wave that reaches next P wave? Think Takotsubo stress cardiomyopathy. Consider intracranial bleed #hcmca16

#hcmca16 use well's criteria to stratify PE risk by d-dimer. Negative d-dimer does not always obviate CTPE or VQ study

#hcmca16 articaine now in dental room. Thiophene motif provides better neuronal penetration -but rare reports of permanent anesthesia w IANB

#hcmca16 paraphimosis not reducing? Penile ring block, grip foreskin with non-crushing clamps at >=2 spots. Pull up and push glans down

#hcmca16 rapid infusion catheter in 3rd drawer down in STAB room. Can turn 20ga IV into bigger than 14ga with higher flow rates than cordis

#hcmca16 waking up w/ a bat in the room is an indication for rabies PEP. May not see bite wound. Use both rabies immunoglobulin and vaccine

#hcmca16 pt has anaphylactoid reaction after eating fish? Think scombroid toxicity- histidine in improperly stored fish agonist @H1 receptor

#hcmca16 Post-LP HA reduced by 1) smaller needle (22g) 2) smaller CSF volume 3) bevel parallel to dural fibers 4) non-cutting needle

Check visual fields for vague eye complaints. If visual field cut in both eyes, lesion is at or behind the optic chiasm #hcmca16

Thrombin Time is the best screening test for the contribution of dabigratran to bleeding problems #hcmca16