LAST

40 yo F, no PMHx, brought to ED for acute onset of shortness of breath, nausea, and vomiting. She was undergoing hair transplantation for traction alopecia at an outpatient surgi-center. BP 79/40, satting 75% on RA. Bedside sono shows you a…

Hydrofluoric Acid Burn

A young man who works in a glass etching factory is rushed to ED for severe pain to his hand after a high concentration chemical solution spilled onto it. He complains of severe pain to the hand in the area of his injury, diffuse abdominal…

Neck flexion injury

A diver shows up to your trauma bay in a c-collar and with complete motor paralysis of legs, torso, hands and weakness of shoulder muscles. He has no sensation to pain or temperature below his clavicles. His proprioception is intact. Which…

TCA overdose

The nurse comes running over from triage to the cardiac room because there’s a patient in triage who claims she took a whole bottle of her imipramine before she went to bed last night (12 hours ago). On exam, patient appears indiffere…

Tumor Lysis Syndrome

A young lad with acute lymphocytic leukemia (ALL) shows up to your ED feeling very weak and c/o sever muscle cramps. On further questioning he reveals that he started chemotherapy 3 days ago. Labs show potassium of 6.5 mEq/L, calcium of 6.3…

Iso Precautions for shingles?

This young lady shows up to your ED with 1 week of rash over her abdomen. The rash was preceded by pain to the area, which improved but still bothers her, and much to her chagrin, the rash still has not resolved. She has no medical problems…

Knee Immobilizer Pearl

53 yo F was walking in high-heeled boots on the cobblestones of the west village. She slipped and suffered a knee twisting injury. On exam, she has an effusion but her plain film is negative for fracture/dislocation. She is in too much pain…

Gum pains

25 y/o F with multiple painful lesions of the right gingiva and low grade fever. The symptoms started off as a stinging sensation with sensitivity to the gums on her right side that she noticed 3 days ago, but now there are lesions that hur…

*Champagne Tap*

Happy New Year SinaiEM! In keeping with the holiday spirit, today’s pearl is a bit about spinal taps, aka Lumbar Puncture. First is a review of what findings you would see for our most common differential diagnosis, and it is followed…

Tentorial Subdural Hemorrhage

Tentorial/Peritentorial Subdural Hemorrhage – rare, but this is what they look like on CT. They may resemble intraparenchymal bleed on CT but MRI can confirm exact location with regard to the tentorium. As a reminder, the tentorium is…

January 2022
M T W T F S S
 12
3456789
10111213141516
17181920212223
24252627282930
31  

Archives