Clinical Pearl: June 29th

Interesting point from Amal Mattu. What historical factors of CP are predictive of ACS? 1) association with diaphoresis 2) association with vomiting 3) association with exertion 4) radiating to both arms or right arm   All others are n…

Clinical Pearl: Tuesday, June 26

Thanks to Brittany for this excellent Peds pearl. A 4 year old boy presents with a fever and a one-day history of rapidly worsening limp at the LLE, now with complete refusal to bear weight or range the L hip. You are concerned about a wide…

Clinical Pearl: Monday, June 25th

28F presents with two months of intermittent fevers and a new murmur.  You suspect infective endocarditis.   With this subacute presentation, how many blood cultures should you order? How far apart?  What empiric antibiotics are indica…

Aneurysm screening

Sweep through large AAA from Sinai EM Ultrasound on Vimeo. Abdominal aortic aneurysm (AAA) affects 5-10% of males age 65-79, and among males over 55 years of age represents the 14th leading cause of death. Ruptured aortic aneurysm is associ…

Clinical Pearl: Friday, June 15

Thanks to A.Hill for today’s pearl: 19M presents with fever and rash on palms and soles x1 week. Vitals: Temp 101 HR 105 BP 130/80 RR 12 O2 100% What is the differential for rash on the palms and soles? Disseminated gonococcus Rocky m…

Clinical Pearl: Tuesday, June 12

Thanks to PEM fellow Brittany for today’s cases. A 1 week old presents with cyanosis and sweating with feeds. No history of fever, preceding illness. O2 sat is 85%. Child is placed on 100% O2 but O2 sat does not improve. What are some…

Clinical Pearl: Monday, June 11

23yo M presents with 2 days of substernal CP associated with fevers and dizziness, he called EMS for a near syncopal episode today. His triage vitals: Temp: 102.1  HR: 105 HR: 126/64 RR: 18 O2: 99% RA Exam: unremarkable exam: no murmurs/rub…

Clinical Pearl: Friday, June 8th

A 20yo M is BIBEMS after falling from a scaffold at a construction site.  He has signs of head trauma. Upon arrival his VS are: T=98.9 HR=75 BP=185/90 RR=12 o2 Sat=99% on NRB His neuro exam: PERRL, moving all extremities eyes open to pain m…

Clinical Peal: Thursday, June 7

The first three pearls from this week did not go out via email, although they are on sinaiem.org   Today’s pearl:   A 45F presents with 3 weeks of CP. Her vitals: Temp 36.8C HR 71 BP 95/65  RR 18 O2 98% RA Her exam is unrema…

E M Pearl, June 1

Tip of the hat to Raj Patel for inspiring this clinical question.   26F h/o lupus is brought into resus for positive sepsis screen at triage.  Patient c/o pleuritic CP, SOB, headache, n/v starting today. Vitals are 101.3  140  74/55  2…

Haiti 2012

  In early May, emergency ultrasound fellow Leila PoSaw and two Mount Sinai senior Emergency Medicine residents on the ultrasound track, Swathi Nadindla and Micah Nite, traveled to Haiti for an ultrasound education project. This projec…

June 2012
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