Abdominal compartment syndrome (ACS) is a condition in which the internal pressure of the abdomen becomes so great that it compromises venous return (and therefore hypotension), organ perfusion, and adequate ventilation.Read more
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A 43-year-old patient arrives to the ED complaining of palpitations. Vitals are HR 298, BP 107/74, SpO2 100% RA, RR 18. The patient is diaphoretic, uncomfortable appearing, and heart sounds are fast and irregular. You obtain an EKG which shows the following: What’s your differential? Atrial fibrillation with bundle branch block Atrial fibrillation with accessoryRead more
The loop technique involves making two incisions at either pole of a skin abscess to initially drain its purulent contents. A loop drain is then inserted into one incision site and out the other, tied off above the skin with some movement of the loop drain allowed. The drain can be cut at follow-up inRead more
The two-point compression ultrasound exam assesses the lower extremity venous system at two points: common femoral vein and popliteal vein. Signs of DVT include lack of compressibility and visualized thrombus. [1]Read more
Diagnostic abdominal paracenteses are frequently performed in the ED for patients with known liver disease. What complications can occur? What if the INR is elevated, as in many patients with liver disease?Read more
A 40 y/o G10P10 presents with RUQ pain worse with fatty foods. When evaluating for acute cholecystitis, what 5 sonographic findings do you look for? What is the Mickey Mouse sign? What is the mantle clock sign?Read more
An 80-year-old male is brought by family for AMS. On initial assessment: BP 86/45, HR 160s, in AFib, tachypneic. While addressing the ABCs, you’re also wondering what diagnostics can be performed immediately to help evaluate this undifferentiated sick patient. Your colleague recommends the RUSH exam, but what is that? [break] RUSH stands for Rapid UltrasoundRead more
32M BIBEMS s/p SW to abdomen. He becomes hypotensive/tachycardic, becomes less responsive. Massive transfusion protocol is initiated. What electrolyte abnormality is caused by massive transfusion? In the 1:1:1 ratio, are we talking about a single dose of platelets or a single unit of platelets?Read more
You are evaluating a 65yo male with PMH CHF presents with severe sepsis. You’d like to administer IV crystalloids but you’re not sure how much should be given. What are some tools to assess for fluid responsiveness?Read more
A recently published retrospective study in the Annals of EM supports the use of an age-adjusted d-dimer cutoff when evaluating patients with possible PE. Standard cutoff = 500 ng/dL; Age-adjusted cutoff = patient’s age x 10 Click for more details….Read more