Clinical Pearl

28 yo M with no pmh presents with HA, fever, and neck stiffness. He states that he recently came back from a week long business trip to Dallas. You get a CTH that is wnl and LP with results below. Pressure Normal Appearance Clear Protein…

Clinical Pearl

A previously healthy 28 yo F presents to your ED with HA, myalgias, abdominal cramps, nausea, vomiting, and diarrhea. She reports recent trip 2 weeks ago to Yosemite National Park where she was camping with her boyfriend. Pt is coughing, so…

ACEP US Section Discussion Forums

If you aren’t a member of the Ultrasound Section or ACEP this is a great reason to become one.     Mike Stone with help from Phil Perera and no doubt others have built a forum where you can find all of the most pertinent dis…

Clinical Pearl August 21th

A 9 day old infant is brought to the ED with difficulty breathing and poor feeding for one day. Pt is found to be tachypneic, mottled, with peripheral cyanosis and no palpable LE pulses.  What’s your diagnosis? What should you do?

Clinical Pearl

Review of Classif ication of Misscarriage: Threatened Ab:  3.4 to 17% with confirmed FHR by.  Rates higher without. References: Tannirandorn Y, Sangsawang S, Manotaya S, et al. Fetal loss in threatened abortion after embryonic/fetal heart a…

Clinical Pearl: August 16.

A nursing home patient presents critically ill with respiratory distress, severe abdominal distension, ascites and oliguria.  You are concerned for abdominal compartment syndrome. How will you make the diagnosis?

A 29 y/o female with NIDDM and poorly controlled chronic asthma present s with 3days of sob and wheezing typical of her prior asthma exacerbations.  After two nebulizer treatments and dose of corticosteroids her PEFR is measured at 55% of p…

A 44 year old female with HTN, DM, and psychiatric disease presents with non-traumatic pain and vision loss in her right eye for 12 hours.  She has a right sided throbbing headache. On exam she has a 5mm R pupil which is sluggish to react,…

A 50 year old man presents with agitation and delirium.  He has sinus tachycardia to 120bpm but his vital signs are otherwise within normal ranges. He answers some questions, but is disoriented, illogical and rambling.  He is picking at “an…

The FALLS-protocol

In critically ill septic shock patients, assessments of hemodynamic function, fluid status and improvement of clinical status are challenging.  As a consequence of critical illness and large volume administration of crystalloids as recomme…

August 2012
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