Jon Chuko @jonchuko

Try clonidine for your opioid-user in active withdrawal. It can help relieve their discomfort significantly. Your nurses will be very thankful. #cincyai

Consider ENT referral for a patient with recurrent nosebleeds with no known history of coagulopathies. Nasopharyngeal carcinoma is on the differential #cincyai

If you suspect retinal detachment or vitreous hemorrhage, don't be shy about putting an ultrasound on the eye. You might confirm your diagnosis! #cincyai

In a patient with suspected appendicitis, try the psoas sign (right hip extension). It can clue you into a retrocecal appedix! #cincyai

One of the most important steps in evaluating a patient coming in for altered mental status is obtaining collateral information. Figuring out what changes from baseline have occurred is essential #cincyai

Positioning the patient, ultrasound machine and arm optimally are critical components of a successful ultrasound-guided IV placement #cincyai

Think about checking a urine in patients with recent history of significant emesis. Significant ketones in the urine could signal prominent dehydration, weight loss and ketosis. #cincyai

Baclofen pump failure can happen. Consider it for patients that have generalized systemic symptoms like drowsiness, nausea, headache, weakness, light-headedness and increased spasticity. #cincyai

Watch out. The infamous Centor scoring system for strep pharyngitis is only mean't for patients with onset of symptoms within 3 days or less. #cincyai

Patients on chemotherapy that come in with pneumonia are classified as HCAP (Healthcare-associated pneumonia). Gotta cover those multidrug-resistant bacterias #cincyai

When you are wondering what to do for a chronic hypertensive patient that presents with hypertension to the ED that has no evidence of end-organ failure and is asymptomatic...start by giving their home hypertension meds that they haven't taken today haha #cincyai

Know your lidocaine toxicity levels in adults: 7 mg/kg with epinephrine and 4 mg/kg without! #cincyai

#cincyai

A meta-analysis looking into the sensitivity of the combination of leukocyte-esterase and nitrite ranged from 68% to 88% in different patient groups. Look for symptoms if you can! ncbi.nlm.nih.gov/pubmed?term=15…

#cincyai

Treatment for tinea capitis includes BOTH topical selenium sulfide or fluconazole with either oral terbinafine or griseofulvin. If left untreated, it can turn into a kerion...

Pregnant patients with new onset headache or change in the character of their previous chronic headaches need to be ruled out for venous sinus thrombosis. MRI and CT venogram of the head with appropriate shielding are both options. #cincyai

When performing paracentesis, if you are unable to aspirate peritoneal fluid, you may be stuck in omentum. Leave your needle in, use a saline flush and try again. #cincyai