Of Things to Come…

What ligament is commonly injured in the condition represented by the above xray. A.UCL B.PCL C.ACL D.LCL E.RCL   Answer : A.  UCL.  This patient has a skier’s or gamekeeper’s thumb.  The ligament damaged or torn is the Ulnar collateral ligament.  The ED treatment is thumb spica, but if the ligament is torn completely, theRead more


  A 70 year old male with a history of chronic constipation presents with abdominal pain.  The patient has normal vitals.  The xray below is taken.   What is the treatment? A. Lactulose B.Straight to the OR for operative management C. Observation D. Barium Enema E. Rectal Tube   Answer : E.  If the patientRead more

Give Me a Hand Here

You are caring for an alcoholic well known to your emergency department.  He presents with intoxication.  His labs are normal, except for an EtOH level of 400.  You monitor him for 8 hours and feed him.  As you’re getting ready to discharge him, you get called away to a trauma.  You come back 2 hoursRead more

A Shocking Development

A 45 year old male playing tennis is struck by lightning and witnessed by bystanders.  He is thrown several feet.  He appears to be in cardiac arrest and CPR is started.  After 5 minutes EMS arrives.  His initial rhythm is asystole.  His pupils are fixed and dilated.  What is the next step in management? A.AmiodaroneRead more

You are currently treating a patient in the ED for a TCA over dose.  She has received bicarb, but go into a sustained ventricular tachycardia, with pulses.   What is the next medication of choice A. Amiodarone B. Propranol C. Electricity D. Lidocaine E. Epinephrine F. Procainamide   Answer – D. lidocaine is the antidysrhythmicRead more

Things That Make Your Heart Slow Down…

Which conditions cause relative bradycardia?   a. Typhoid fever (Salmonella typhi) b. Malaria c. Legionnaire’s disease (Legionella pneumophila) d. Rocky Mountain Spotty Fever e. Infectious mononucleosis f. Pneumonia 2/2 Chlamydia g. SIRS h. Hantavirus  Read more

Wha Happened?

A 19 year old female with a pmh of acne presents with the Emergency Department for the second time in 3 months with a complaint of epigastric pain.  She states that the last episode resolved after 3 without speaking to her doctor.  Her pain is accompanied with nausea and vomiting.  She states that before theseRead more

AAEM 2014 Preconference ultrasound course

Mike Lambert has once again outdone himself, organizing the annual preconference ultrasound course at the American Academy of Emergency Medicine Conference in New York City. Mount Sinai faculty Bret Nelson, Amy Sanghvi, and Jennifer Huang were among a group of faculty hailing from across the globe.Read more

Chest Pain

A 65 year old Female Presents to the ED with a complaints of severe chest pain. Her medical history is significant for HTN, DM, HLD. The patient states the pain started after she was told Derek Jeter was going to retire Her EKG is below As the patient is being wheeled to the cath lab,Read more

SonoSweden 2014 course

At the end of January, Bret Nelson joined an incredible team of international a faculty for the largest SonoSweden course to date. Course director Christofer Muhr hosted this unique, intensive hands-on conference at the scenic Yasuragi hotel in Stockholm, Sweden. Over thirty faculty and one hundred participants took part in this three-day course. Among the facultyRead more