A 21 y/o M presents with chest pain and sudden syncope while walking to class earlier this morning. He had no other preceding symptoms. There was no seizure activity reported by witnesses. He denies any past medical or surgical history. He reports he thinks his father has an abnormal heart rhythm, but isn’t aware ofRead more

Sinai Daily Pearl 10/25

An infant is brought in with increased irritability x 2 days. The parents note that she hasn’t had any remarkable symptoms – no fever, cough, congestion, vomiting, diarrhea. She is tolerating feeds, but more fussy than usual. Your initial exam is normal. The mother later directs you to take a closer look at the infant’sRead more

The Vomiting Child – Multiple Choice Q&a

1. A 14 month old child is brought into the ED for fevers, vomiting, diarrhea x 4 days. Stools are watery and nonbloody. The infant appears nontoxic and well hydrated. The patient attends day care. What is the most likely diagnosis? a) Campylobacter b) Rotavirus c) Shigella d) Salmonella e) Norwalk virus 2. A 3Read more

Abdominal Pain in a Young Male

 A 14 y/o M presents to the ED complaining of severe intermittent low abdominal pain x 2 hours. His symptoms began after he awoke from sleep to urinate, and have been unremitting since. No history of trauma. He vomited once, 20 minutes prior to arrival. His abdominal exam is benign. He appears very uncomfortable andRead more

Reflections from a First Ed Thoracotomy

Requested by Dr. Strayer as written by Dr. Porat – “As EMS was puling up someone came into the trauma bay and yelled “he just lost his pulse.” This gave me time to grab the thoracotomy tray and open it up. These extra 2 minutes gave me time to open the tray, remind myself whatRead more

Second World Congress on Ultrasound in Medical Education

The University of South Carolina once again hosted the incredible World Congress on Ultrasound in Medical Education in Columbia. Dean Richard Hoppmann hosted over 100 faculty and hundreds of attendees, with dozens of countries represented. Mount Sinai emergency ultrasound director Bret Nelson gave a plenary talk on the use of ultrasound in remote environments, from theRead more

2013 Ultrasound Fellow Graduation

We were proud to graduate three ultrasound fellows this year: Kim Poh Chan, our international fellow who will return to Singapore and head up a new ultrasound program Daniel Lakoff, who will co-direct the ultrasound program at Elmhurst Hospital, and Ee Tay, our first pediatric emergency ultrasound fellow, who will remain at Sinai Left toRead more

The Pre-reduction Film for Anterior Shoulder Dislocations

You get a patient in triage with an anterior shoulder dislocation that happened 10 minutes prior to arrival. It’s happened to him multiple times on the same shoulder and all he did to dislocate it was to push up from a chair. You really want to get it reduced quickly because you are smart enoughRead more

Pulse Ox Issues

We’ve all experienced it. There’s an intubated patient who is stable, saturating >98% on pulse ox, and then all of a sudden you hear the monitor start alarming and the SpO2 is plummeting. Lets assume that all other vitals are unchanged and no vent alarms are going off. Nothing on exam has changed except forRead more