A resident of ill-repute was minding his own business on the way to his shift when he was assaulted. He complains of nose pain and that conference is too early in the morning. The attending was anxiously awaiting the arrival o…
Try Bret’s expert tips to improve RUQ view and finding the GB using the sonographic rib spreader! http://sinaiem.us/tips-and-tricks/improving-left-upper-quadrant-view
Chilly day, time to review frostbite recommendations….
You have a patient sent by her PMD for a UTI. She had just received her culture results showing ESBL that is susceptible only to carbapenems. The PMD wants her admitted for IV antibiotics. She has no other symptoms. Is there a way to avoid…
Rob Rogers gave a great lecture on aortic dissection at the NYU Med Ed conference yesterday. Here are the highlights: -not common, but it is a killer -classic presentation in 1/3 -aortic dissection can be subtle (isolated abdominal/extremit…
Thank you for going for our click bait! Approximately 41,000 blood transfusions are needed daily in the United States. While transfusions are largely safe and save countless lives, here are five pearls you should know. 1. The most common ad…
A 50-year old man with atrial fibrillation and off of warfarin for the past 6 months comes to you with many complaints. But the one that catches your eye (pun intended. zing!), is that he complains of blurry vision. 1. What is the single mo…
A 50-year old man with no known medical history (“I don’t see doctors. I don’t like doctors.”) presents to the ED because he crashed his car into a pole after driving after a “wintry mix” weather event (#…
A 78-year old man presents with abdominal pain and decreased oral intake. His vitals are normal but he looks uncomfortable. After you introduce yourself, you palpate his abdomen which is diffusely tender. Your immediate gestalt is “Sm…
Chief complaint: Hiccups (i.e. “singultus”). Timing: 3 days. Diagnosis: Persistent hiccups. Etiology: Unknown. Who cares? You care. Why? Because persistent hiccups (>48 hours) and intractable hiccups (>1 month!) is likely…
PEM fellow Dr. Michelle Vazquez presents a case of: A 6 month old boy comes to the ED with an elevated respiratory rate and lots of wheezing on exam. He had a tactile fever at home and in the ED his temperature is measured at 100.4F. His ox…
A young woman presents to the Emergency Department with chest pain of sudden onset while blowing up a balloon at her kid’s birthday party. Vitals are normal but due to slightly decreased breath sounds on the left, you are concerned fo…
Nurse: Doctor, this patient is a tough stick. I tried 3 times and I got nothing. Can you help? Doctor: Sure! I’ll grab the linear ultrasound vessel finder and get that line in for you, thereby potentially saving this non-critically ill pati…
Your 14 year old male patient fails the Ottawa Knee or Pittburgh Knee clinical decision tool after gettting whacked in the knee with some object of some kind or another. He’s tender near the tibial tuberosity and he refuses to extend…
A 75-year old man comes to your Emergency Department with an acute onset of left sided weakness and a facial droop. His NIH Stroke scale is 15. A stroke alert is called and the stroke fellow and her team race-walks to the Emergency Departme…
