A 50yoM with h/o MI >5 years ago presents with a heart rate of 150, only complaining of palpitations, and otherwise normal vital signs. States he was told he had some type of arrhythmia in the past with similar symptoms, and was given a…
This year AIUM is hosting its annual conference at the JW Marriott Desert Ridge Resort and Spa in Phoenix, AZ. The first offering by the Emergency and Critical Care Community of Practice was a great success. The conference proper hasn…
Many of our lectures reference the same pantheon of literature on ultrasound in the acutely hypotensive patient. For ease of reference here they are, with appropriate links to the original publications: UHP protocol Rose JS et al, Am J Em…
Today’s pearl was inspired by Vincent Roddy A 38-year-old man presents to the emergency department 6 weeks after Roux-en-Y gastric bypass with recurrent abdominal pain, nausea, and bilious vomiting. He has had 3 total episodes during…
A 30yoM presents with a GCS of 7 after a trauma to the head, shallow respirations, saturating 100% RA, otherwise normal vitals. You decide that the patient needs to be intubated and begin preparing your equipment. You place the patient on…
A 6 day old baby presents pale and lethargic. HR 200, BP undetectable, O2 saturation 90%, RR: 40, finger stick 20. You give dextrose but symptoms do not improve. You suspect congenital heart disease and confirm this with a hyperoxia test. Y…
A 66yoM with advanced CHF s/p LVAD, who was in his usual state of health, presents because he felt his AICD fire multiple times. In the ED, his rhythm shows ventricular tachycardia. A pulse, blood pressure or oxygen saturation cannot be obt…
A 60yoM with h/o hypertension presents with palpitations x 24 hours. He has never had this before. In the ED, he has normal vital signs but his rhythm shows atrial fibrillation. You do blood tests including a ddimer, BMP, troponin, and a ch…
In light of the ultrasound conference that very few of us could attend: A dialysis patient presents with mild hypotension and respiratory distress. Bedside ultrasound was done with the parasternal long view shown below. You are unable to ac…
A 30yoM stabbed in the left 4th IC space suddenly arrests as he rolls into the trauma bay. You perform a left sided thoracotomy, open the pericardium, to find a laceration to the left ventricle which you put your index finger over, successf…
Congratulations to Sinai’s own Dr. Jim Tsung, who recently coauthored a major evidence-based consensus guideline on point-of-care lung ultrasound. The manuscript is the result of a multi-national effort by pioneering clinician-sonogra…
A 45 y/o F with a pmh of gastric bypass surgery presents to the ED for evaluation of copious diarrhea x 3 days. The patient appears weak, dehydrated, and sluggish. During your ED evaluation the patient has an acute onset tonic-colonic sei…
A 66 y/o M with pmh of HTN presents to the ED for evaluation of acute onset right eye pain, blurred vision, nausea and vomiting. The patient reports being in his usual state of health until he took a small dose of benadryl to help him slee…
A 12 y/o M with a pmh of sickle cell disease presents to the ED for evaluation of chest pain and sob x 1 day’s duration. The child appears in mild respiratory distress, vs are normal with exception of the SpO2 of 93% on RA. Below is the che…
A 19 y/o M was playing baseball and was accidentally hit in the eye with the ball. The patient is reporting eye pain and slightly blurred vision. On inspection in the ED his vision is 20/20 bilaterally, however this physical exam abnormal…
