Scuba Do

A 33 yo  man presents to the ED with multiple complaints 2 hours after completing a scuba dive.  Which of the following symptoms indicates a need for recompression therapy? Decreased hearing Ear pain Epistaxis Knee pain Petechial rashRead more

My Aicd Won’t Stop Firing!

65 yo M PMH of HTN, CAD, CHF (EF <30%), AICD wheeled into the cardiac room saying that he is getting shocked every 30 seconds. Vitals: T 36 HR 45 BP 205/100 RR 30 O2 sat 100% RA. Pt is placed on a monitor, EKG done which shows atrial fibrillation with slow ventricular rate.  ARead more

Can’t Put My Finger on It

A 29 year old male resident presents to the local emergency department directly from the residency ski trip.  He was cruising down the slopes at  high speed, hit a hidden patch of ice and fell onto his right hand, hyperextending his thumb.  He tried to avoid coming to the emergency department, but the thumb remainsRead more

January 23rd NYC RESUS Rounds

Spectacular rounds this week lead by Sahar Ahmad of Stonybrook and hosted by Pierre at BI. Sahar gave a great presentation on her didactic program for the critical care fellows at Stonybrook.  She then presented a series of discussion inducing cases.  Carl Kaplan (of Stonybrook not RUSH) presented an interesting case of ONSD ultrasound forRead more

Face off

A 29 y/o M presents to your ED after a head-on MVC at moderate speed.  The patient was driving an older automobile without airbags, and smashed his face hard against the steering wheel.  He has significant facial ecchymoses and swelling, and you note clear fluid continuing to drain from his nose.  What injury will likelyRead more

Doc, He’s Acting a Little… Squirrelly

39 y/o F presents to your ED after a bite from a squirrel.  She was attempting to feed to squirrels in Central Park when one of them bit down hard on the index finger of her dominant hand, drawing blood.  She does not report any unusual behavior from the squirrel, although she admits she isRead more

Ouch, My Back

34 yo M BIBA s/p fall from 3 stories, suicidal attempt. Pt is AO3, CTA b/l, pelvis stable, able to lift all extremities off stretcher, sensation and peripheral pulses intact. Pt has right lateral heel/ankle deformity. +step off L1-L2 area, good rectal tone. Red trauma was activated. CT shows compression fracture of L1 with loss of vertebral height ofRead more

Urinary Tract Infection & Pregnancy

An 8 month pregnant female arrives to the ED complaining about dysuria. She is nontoxic appearing, afebrile. Exam significant for +suprapubic tenderness, -CVA tenderness. UA +leuks, +nitrates. 1) What antibiotic regimen should she be started on as an outpatient? 2) What if she had fever, +CVA tenderness, or systemic findings consistent with pyelonephritis?   Options:Read more

Lovely Patagonia

32 yo M no sig PMH presents to ED with low grade, fevers, cough, SOB, and bodyaches for 4-5 days, symptoms are getting progressively worse. Pt had abdominal cramping, nausea, and diarrhea that preceded respiratory symptoms and began 1-2 weeks ago. He recently came back 2 days ago from Patagonia, Chile where he was campingRead more

More Than Just Teenage Angst

An 18 year old female presents to the ED with vague symptoms of lower back pain. She exhibited inappropriate and erratic behavior that seemed more than just teenage angst. The patient was thin in NAD and had a grossly normal musculoskeletal, motor and neuro exam, no red flags. Labs were drawn and she had aRead more