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Clinical Pearl

28 yo M with no pmh presents with HA, fever, and neck stiffness. He states that he recently came back from a week long business trip to Dallas. You get a CTH that is wnl and LP with results below. Pressure Normal Appearance Clear Protein < 1 g/L Glucose wnl Gm stain negative Lymphocyte predominanceRead more

Clinical Pearl

A previously healthy 28 yo F presents to your ED with HA, myalgias, abdominal cramps, nausea, vomiting, and diarrhea. She reports recent trip 2 weeks ago to Yosemite National Park where she was camping with her boyfriend. Pt is coughing, sob, febrile and appears unwell in pain. She mentions that there was some warning whileRead more

ACEP US Section Discussion Forums

If you aren’t a member of the Ultrasound Section or ACEP this is a great reason to become one.     Mike Stone with help from Phil Perera and no doubt others have built a forum where you can find all of the most pertinent discussions from the section list-serve. There are a few choiceRead more

Clinical Pearl August 21th

A 9 day old infant is brought to the ED with difficulty breathing and poor feeding for one day. Pt is found to be tachypneic, mottled, with peripheral cyanosis and no palpable LE pulses.  What’s your diagnosis? What should you do?Read more

Clinical Pearl

Review of Classif ication of Misscarriage: Threatened Ab:  3.4 to 17% with confirmed FHR by.  Rates higher without. References: Tannirandorn Y, Sangsawang S, Manotaya S, et al. Fetal loss in threatened abortion after embryonic/fetal heart activity. Int J Gynaecol Obstet 2003; 81:263. Schorge JO, Schaffer JI, Pietz J, Halvorson LM, Hoffman BL, Bradshaw KD, CunninghamRead more

Clinical Pearl: August 17th

60F with fatigue and decreased alertness.  What is the diagnosis?Read more

Clinical Pearl: August 16.

A nursing home patient presents critically ill with respiratory distress, severe abdominal distension, ascites and oliguria.  You are concerned for abdominal compartment syndrome. How will you make the diagnosis?Read more

Clinical Pearl: August 10

Look familiar? This is the yesterday’s ECG taken from Sgarbossa et al.  1996.  Is this a true LBBB?Read more

68F with chest pain.  No prior ECG. What is going on here?  Read more

A 29 y/o female with NIDDM and poorly controlled chronic asthma present s with 3days of sob and wheezing typical of her prior asthma exacerbations.  After two nebulizer treatments and dose of corticosteroids her PEFR is measured at 55% of predicted.  Should she be admitted?Read more