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.
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.
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.
Why Weight Loss Is So Hard (And What Actually Works)
Dr. Adrian Cois breaks down one of the most misunderstood medical conditions in modern healthcare: obesity.
Hypertension – Don’t blow your top – get it under control!
Should we be starting antihypertensives from the Emergency Room?
Here I make a case for considering it and if you have high blood pressure - give you some great tips on how to manage it without blood pressure medicine.