60 y/o F with PMHx of HTN and DM presents after striking head on piping in garage ~1 hr prior. Pt was standing up after getting out of a car and walked into pole. Remembers incident fully. Currently complaining of dizziness, mild tempora…
For Friday’s missed pearl:
A 4-year-old boy comes to the ED with a severe sore throat and history of “refusing to eat”. He has severe pharyngitis on exam an you are concerned that he may have a retro pharyngeal abscess. What technique should be use…
Buckyballs are extreme magnets marketed to adults. There have been several case reports of intestinal perforation following ingestion of multiple balls. The magnets stick together through intestinal wall resulting in perforation. Ingesti…
If you see a patient who has been involved in a physical altercation make sure to check their hands for signs of abrasions/lacerations as these may represent “fight bites”. If you seen any damage to the skin you should treat th…
Impetigo is a type of bacterial rash normally occuring on the face and extremities that progresses from papules to vesicles to pustules then crusts. There are two main sub types of impetigo: non-bullous and bullous (caused by S. aureus tha…
Temporary cardiac pacing: electrical stimulation to heart to treat tachyarrhythmia or bradyarrhythmia Transcutaneous: pacing through the skin Complications: significant pain (requires sedation), decreased reliability Transvenous: Insert th…
Pericardial effusion – accomulation of fluid within the pericardium Causes of effusion infection: viral, bacterial, TB, fungal – viral, purulent, TB drugs and toxins autoimmune disease metabolic disorders – uremia, dialysi…
Dengue fever Epidemiology: ~ 50 million cases per year, mosquito vector disease Disease syndrome has clinical variability from asymptomatic infection to dengue hemorrhagic fever with shock syndrome Incubation period — ranges from 3 to 14…
Arthrocentesis is the removal of fluid from a joint. It is indicated for diagnostic and therapeutic reasons. It can help to differentiate infection, hemorrhagic, and rheumatologic etiologies of joint effusion. Fluid should be sent for ce…
What imaging should you use to diagnose PE? Based on PIOPED study, patients with high clinical probability of PE and a high-probability V/Q scan had a 95 percent likelihood of having PE. Patients with low clinical probability of PE and a lo…
Dx: Jones fracture Ankle and foot paint are common presenting complaints to the emergency department. It is important to be able to tell the difference between a Jones fracture displayed above and a Pseudo-jones fracture. Both of these fr…
Dx: Subarachnoid hemorrhage Risk factors include hypertension, smoking, polycystic kidney disease, family history, and connective tissue disorders. Subarachnoid hemorrhages are related to ruptured arteriovenous malformations, bleeding disor…
Safe wishes to everyone from TR A disaster is defined as an inability to meet current needs due to some event either internal or external (ie. Natural disaster, terrorist, man-made) Disaster Preparedness and Response – follow these steps (…
Ischemic stroke management (based on Sinai protocol) Labs: FS, electrolytes, CBC, coags, cardiac enzymes Radiology: CT head Indications for tPA: ischemic stroke, definite time of onset, NIHSS>1, no hemorrhage on head CT, onset of symptom…
