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Pearl for 12/21

A 25 yo male with no PMH walks into your ED complaining of right neck pain, right shoulder stiffness,  and cough x 1 month, no fevers chills. On exam his vitals are all within normal limits, exam is notable for right sided swelling and asymmetric neck. CXR as below:       What are youRead more

Clinical Pearl

26 M pmh sickle cell disease p/w chest pain, sob, fever, and cough. She is noted to be hypoxic, anemic and has new pulmonary infiltrates on cxr. What diagnosis must be considered?   A: Acute chest syndrome “Acute chest syndrome is a clinical entity marked by hypoxia, fever and pulmonary infiltrates. Many EPs are confusedRead more

Daily Em Pearl 4/15/12

A pleasant 64yoM w/NIDDM and afib (on coumadin) p/w an abscess to R-medial thigh. He is afeb but there is some surrounding erythema at the abscess site. You perform a thorough incision and drainage and instruct him to return in 2days for wound check; he is discharged with bactrim DS 2tabs BID for 10days. HeRead more

Daily EM Pearl 4/5

A 60yoM h/o A-Fib on Dabigatran, took his medication this morning and then slipped in the shower 10 mins later, hitting his head with +LOC. He did not want to come to the emergency room at first but approximately 14 hours later, complains of worsening headache, nausea, and vomiting. CT shows a parietal subdural hematoma.Read more