Comments for ercast.org http://blog.ercast.org Emergency medicine podcasts, reviews and curbside consults Sat, 20 Sep 2014 17:46:48 +0000 hourly 1 http://wordpress.org/?v=3.9.2 Comment on Is it really a sinus headache? by Rob Ormanhttp://blog.ercast.org/really-sinus-headache/#comment-847 Sat, 20 Sep 2014 17:46:48 +0000 http://blog.ercast.org/?p=2912#comment-847 Hi Jenny,
I think it’s a matter of research criteria versus real world medicine. I agree, the vast majority of patients are going to take some kind of med. This would technically invalidate that aspect of the POUNDing criteria. I think if the patient’s has a history of headaches lasting in that time interval, or headache has been going on over 4 hours before they come to the ED -- good enough for me. It does not follow the letter of the mnemonic, but we are working in the grey, whereas entry criteria into a study is always going to be black and white.
Here is a link to the study that discussed the mnemonic (amongst other things)
http://ccdimager.net/familypracticesource/Top%20Ten%20Priority%20Topics%20Cited%20by%20Pracitising%20FPs/Headache/headache%20pdf.pdf

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Comment on Is it really a sinus headache? by Jennyhttp://blog.ercast.org/really-sinus-headache/#comment-846 Sat, 20 Sep 2014 04:33:55 +0000 http://blog.ercast.org/?p=2912#comment-846 sorry -- that was probably confusing the way I wrote it -- my sincere apologies -- in your pound mnemonic to help determine if its a migraine, number 2 is “Does it last between 4 and 72 hours without medication?” I feel like this is tough to obtain an answer of yes from patients as most people have at least tried motrin or tylenol (even if they did not take migraine meds) before coming to the ed with a severe headache. Thanks and sorry for the confusion.

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Comment on Pulmonary embolism in pregnancy with Jeff Kline by Rob Ormanhttp://blog.ercast.org/pulmonary-embolism-in-pregnancy/#comment-845 Wed, 17 Sep 2014 04:02:13 +0000 http://blog.ercast.org/?p=2170#comment-845 Agreed, James. Jeff and I discussed this at Essentials of Emergency Medicine last year (can be found in the digital download) as well as on an upcoming EMRAP (probably early 2015). There is literature supporting increased cutoffs for d-dimer in pregnancy, but no consistent data showing that these are the hard cutoffs.

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Comment on Is it really a sinus headache? by Rob Ormanhttp://blog.ercast.org/really-sinus-headache/#comment-844 Wed, 17 Sep 2014 03:58:54 +0000 http://blog.ercast.org/?p=2912#comment-844 Hi Jenny,
I’m not completely sure what you’re asking. If it’s should one wait 4 hours after headache onset to initiate treatment, the answer is no. The earlier the better. Triptans are OK, but no better than ASA+APAP+caffeine, metaclopramide or prochlorperazine. Does that answer the question?

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Comment on Splint like a pro by Rob Ormanhttp://blog.ercast.org/splint-like-a-pro/#comment-843 Wed, 17 Sep 2014 03:56:13 +0000 http://blog.ercast.org/?page_id=1928#comment-843 Colles’ fracture/ Sugartong splint is now posted!

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Comment on Is it really a sinus headache? by Jennyhttp://blog.ercast.org/really-sinus-headache/#comment-842 Wed, 17 Sep 2014 01:31:24 +0000 http://blog.ercast.org/?p=2912#comment-842 Dr. Orman, Good Lecture!! To have 4 or more positive and an LR of 24, does the 4-72 hours without meds include all medications or is it referring to more migraine type meds like sumatriptan? if so, that would be hard, as most pt try at least tylenol or motrin at home. Thanks.

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Comment on Splint like a pro by Rashahttp://blog.ercast.org/splint-like-a-pro/#comment-841 Fri, 12 Sep 2014 10:05:35 +0000 http://blog.ercast.org/?page_id=1928#comment-841 These videos are great. Hope you can share with us splinting Colles fracture and sugar tong splints

Thank you

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Comment on Pulmonary Nodule: The incidentaloma by jeffhttp://blog.ercast.org/pulmonary-nodule-incidentaloma/#comment-840 Thu, 11 Sep 2014 17:41:23 +0000 http://blog.ercast.org/?p=2455#comment-840 Had 3 lung nodules 2 in my left, 1 in my right, smallest one was 1.5 cm, largest was 2.8x2.9, found on ct scan, they were multi focal and I’ll defined, had pet scan about one week later and after antibiotics. Pet revealed all had shrunk to half the size and had minimum to none uptake ruled infection followup ct in 3 weeks.Thought this may help some anxiety in some patients.

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Comment on Splint like a pro by Episode 14 – Hand | FOAMcasthttp://blog.ercast.org/splint-like-a-pro/#comment-839 Thu, 11 Sep 2014 15:41:30 +0000 http://blog.ercast.org/?page_id=1928#comment-839 […] to Splint Like a Pro (via ERCast) and document a thorough neurovascular exam pre and […]

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Comment on Splint like a pro by Porsche reyeshttp://blog.ercast.org/splint-like-a-pro/#comment-837 Sun, 31 Aug 2014 04:07:07 +0000 http://blog.ercast.org/?page_id=1928#comment-837 Thank you so much for this video! It’s very informative and it helped me a lot during my demonstration and reporting in class :) Good bless!

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