Lung Ultrasound vs Chest X-Ray for Pneumonia: What the Evidence Actually Shows
Checked against CT, the chest X-ray misses about 1 in 4 pneumonias. An ED physician appraises the lung ultrasound evidence and what it should change.
Four Companies Stand Between You and Your Prescription
What Is a PBM? 4 Companies Control 75% of Drug Pricing
He Came In For an Abscess. He Left With Type 2 Diabetes.
Your A1c reflects 3 months of blood sugar, not one morning. An ER doctor explains the 3 diabetes tests, who needs screening, and the fasting insulin myth.
Stroke or Not? The 6 Signs You Cannot Wait On
Stroke symptoms that resolve are not an all-clear. An ER doctor explains BE FAST, the treatment windows, and what to do in the first 5 minutes.
GLP-1 Drugs, Explained: What the Evidence Actually Shows and the One Thing Nobody Tells You
An ER doctor runs Ozempic, Wegovy and Mounjaro through a medication framework. The real benefits, the real side effects, and the one thing you must tell your surgeon.
An ER doctor breaks down LDL, HDL, triglycerides, ApoB and Lp(a), what each number actually means, and which claims about cholesterol do not hold up.
Is This Chest Pain a Heart Attack? What an Emergency Physician Wants You to Know
An ER physician on the warning signs of a heart attack, why you cannot rule out your own, and exactly what to do in the first 10 minutes.
How to Think About Any Medication
An ER doctor’s framework for any medication: spot the 4 tricks used to scare you, then ask the 4 questions that actually matter. Evidence-based, no fearmongering.
The Silent Number: Should the Emergency Department Treat Asymptomatic Hypertension at All?
A high blood pressure reading in a patient who feels fine. New evidence on prescribing at discharge, what the guideline says, and what to do next.
Five Bottles, One Answer: Do Opioids Really Relieve Acute Musculoskeletal Pain Better?
A 600-patient RCT compared 5 oral analgesics for acute musculoskeletal pain. The opioid arms offered no extra relief, only more nausea. Here is the evidence.
Bougie as a Backup? Why I’m Moving It to Plan A
A 2024 meta-analysis of 18 studies and 9,151 patients on whether a bougie improves first-attempt intubation success — and when to reach for it.
Look Before You Leap: What the JAMA 2024 Video Laryngoscopy Trial Means for Your Airway Practice
A JAMA 2024 cluster-randomized trial found video laryngoscopy sharply cut multiple intubation attempts vs direct. Here's how it should change your practice.
Fluoride causes low IQ?
A 2025 JAMA Pediatrics paper linked fluoride to lower IQ in kids, and the headlines ran wild. Dr Cois, an ER physician, reads the actual study — PICO, results, and the cherry-picking tactic that weaponized it. You’ll learn where the signal is real, where it vanishes, and what to tell worried patients.
Read a Paper Like a Scientist: An ED Doctor’s Three-Question Framework for Health Information
Misinformation is the #1 short-term global risk. An ED physician shares the three-question framework doctors use to evaluate any medical paper.
I Paid $9 for a Drug My Pharmacy Said Cost $90. Here’s What’s Actually Going On.
An ER doctor explains why GoodRx can be cheaper than insurance, how Pharmacy Benefit Managers (PBMs) set drug prices, and 3 steps to cut your prescription costs at the counter.
The Paper That Made Me Rename Normal Saline
In the SALT-ED trial of 13,347 noncritically ill adults receiving IV fluids in the emergency department, balanced crystalloids (mainly lactated Ringer's) reduced major adverse kidney events at 30 days compared with normal saline (4.7% vs 5.6%; adjusted OR 0.82, 95% CI 0.70–0.95, P=0.01). There was no difference in hospital-free days. The proposed mechanism is the supraphysiologic chloride load in saline, which causes hyperchloremic metabolic acidosis.
The Boring Longevity Playbook: Why I Stopped Trusting Supplement Stacks
An emergency physician's evidence-based playbook for longevity — the 5 Tier 1 pillars that actually work, plus a free 16-week roadmap.
The Biggest Sleep Mistake Shift Workers Make (And It's Not Caffeine)
An ER physician's evidence-based sleep playbook for night-shift workers. Four circadian behaviours plus three environmental levers you can apply tonight.
Abdominal Pain ER Visit: 4 Diagnoses We Cannot Miss
An ER doctor walks through what really happens when you come in with abdominal pain — the 4 diagnoses we cannot miss, and why most cases come back to food.
What Actually Happens When You Come to the ER with Chest Pain
When you arrive at the Emergency Department with chest pain, your doctor evaluates three main body systems: the heart, the lungs, and the gastrointestinal tract. The first tests are typically an ECG and bloodwork (including troponin), often followed by a chest X-ray. If a heart attack is suspected, you may be sent directly to the cath lab. Additional imaging — such as a CT angiogram — is reserved for higher-risk presentations like suspected pulmonary embolism or aortic dissection.