Eric Moyer

Rush Medical College Class of 2020 | Aspiring EM physician

[Eric Moyer @EricPaulMoyer]

Ever wanted to know how to diagnose/treat the different altitude illnesses? Check out my infographic I posted to our #NYPemdc website about the worst hike EVER! https://t.co/OUx6laAgIb @EMedBound

[Eric Moyer @EricPaulMoyer]

A 2018 study showed that less than 4% of patients who received imaging in their syncope evaluation had an abnormal finding. Factors to look out for include focal neuro deficits, history of malignancy, hypertension, or age greater than 60.
https://t.co/yVIyoLV0Xe
#FoaM4Cook

[Eric Moyer @EricPaulMoyer]

Murphy's sign is a common physical exam maneuver in acute cholecystitis. In one study, using cholescintigraphy as the gold standard, the sensitivity and specificity of a positive Murphy's sign were 97 and 48 percent, respectively!
https://t.co/e35kxekfnU
@CookCountyEM #FoaM4Cook

[Eric Moyer @EricPaulMoyer]

If there is concern for strangulated hernia, don't attempt hernia reduction. Reintroduction of ischemic bowel back into peritoneal cavity can result in sepsis. Techniques for helping reduce an incarcerated hernia include ice and Trendelenberg positioning.
@CookCountyEM #FoaM4Cook

[Eric Moyer @EricPaulMoyer]

Current studies support the use of alpha-blockers (tamsulosin 0.4mg) as medical expulsive therapy without lithotripsy for facilitating passage and time to passage of symptomatic ureteral stones <10 mm in diameter!
https://t.co/uxFWcGCymv
@CookCountyEM #FoaM4Cook

[Eric Moyer @EricPaulMoyer]

Diagnostic Criteria for Acute Pericarditis
2 of the following:
-Chest pain (typically sharp and pleuritic, improved with sitting up and leaning forward)
-Pericardial friction rub
-New/worsening pericardial effusion
-ECG changes
https://t.co/z4dmKMONr5
@CookCountyEM #FoaM4Cook

[Eric Moyer @EricPaulMoyer]

With hyperkalemia, make sure to check if the sample was hemolyzed! If there is true hyperkalemia, check the EKG for any changes or the patient for muscle weakness/paralysis to decide whether it is a hyperkalemic emergency!
@CookCountyEM #FoaM4Cook

[Eric Moyer @EricPaulMoyer]

Patients with recent exposure to chlamydia should receive empiric treatment! Effective antibiotics: a single dose of 1000mg azithro or doxycycline 100mg BID for seven days. Azithro is preferably used due to ability for direct observation of completion.
@CookCountyEM #FoaM4Cook

[Eric Moyer @EricPaulMoyer]

Use the NEXUS C-Spine Rule to clear patients from cervical spine fracture clinically, without imaging! None of the following can be present:
-Focal Neurologic deficit
-Midline spinal tenderness
-AMS
-Intoxication
-Distracting Injury
@CookCountyEM #FoaM4Cook

[Eric Moyer @EricPaulMoyer]

The four clinical factors that increase likelihood of ACS are:
- Chest pain that radiates to both arms > right arm > left arm
- Chest pain with diaphoresis
- Chest pain with nausea/vomiting
- Chest pain with exertion
https://t.co/p9Vr0AQ8yR
@CookCountyEM #FoaM4Cook

[Eric Moyer @EricPaulMoyer]

When assessing the lateral view of a C-spine X-ray, after determining if the film is adequate, it is important to assess for alignment! The lines shown below should be slightly lordotic, smooth, and without step-off.
Source: https://t.co/LELIy2YS49
@CookCountyEM #FoaM4Cook

[Eric Moyer @EricPaulMoyer]

The "GI Cocktail" often refers to a mixture of viscous lidocaine, PO antacid (Maalox), and Donnatal. While often used, according to this randomized double blind clinical trial in 2003, it is no more effective than antacid alone. https://t.co/FmGhu19wgO @CookCountyEM #FoaM4Cook

[Eric Moyer @EricPaulMoyer]

Don't forget the indications for emergent dialysis! Use the mneumonic:
A - Acidosis
E - Electrolyte Imbalances (Mostly hyperkalemia)
I - Ingestion (methanol, ethylene glycol, salicylates, lithium, etc.)
O - Overload (volume)
U - Uremia
@CookCountyEM #FoaM4Cook

[Eric Moyer @EricPaulMoyer]

Clinical pearl from my attending last shift: While ACTIVE cancer is a provoking factor for VTE, history of treated cancer in remission is NOT associated with increased VTE risk! https://t.co/6tozwegrVr @CookCountyEM #FoaM4Cook