On April 18 the FDA released an alert regarding Other-Sonic Generic Ultrasound Transmission Gel, manufactured by Pharmaceutical Innovations Inc. The ultrasound gel was found to be contaminated with Pseudomonas aeruginosa and Klebsiella oxyt…
A young man presents with a slam dunk appendicitis. You start IV abx, order pre-op labs and request surg to come see the patient. Surgery chats with the young fellow, lays hands on his abd and reviews the labs and CT. They recommend IV abx…
A young man is brought in by his buddy because he’s “freaking out.” He isn’t making any sense to you but expresses fear that he’s going to die. He is having visual hallucinations. The friend reports they were h…
Abscess: After incision and drainage, do you pack or not? What does the literature say?
An elderly man presents to the ED after falling down a flight of stairs at home. He has mild but worsening dementia and his wife called EMS when he couldn’t stand up from the fall. Your patient still does his own ADLs but is progressi…
A young woman precipitously delivers a 34wk gestation neonate in your ED. The mother is physically doing well and you turn your attention to the neonate, whose HR is 105 but falling. You prepare for a possible neonatal intubation and alert…
We are pleased to present our annual critical care ultrasound pre-conference course at the Clinical Decision Making in Emergency Medicine symposium in Ponte Vedra, Florida on Wednesday, June 20. Each year this intensive, hands on course fea…
A 6yoM is brought by his guardian for intermittent crying, c/o abd pain for the past two days; he has vomited 4times over the past 2days. He has had no fever and has never had anything like this before. At home his urine has been dark, and…
Early in the morning, a young man p/w R-great toe pain after having his foot stepped on while dancing last night (a few hours ago). On exam, you appreciate full ROM and strength but your patient is pretty uncomfortable. He took paracetamol…
Emergency physician, intensivist, and Mount Sinai Emergency Ultrasound Fellowship graduate Dr. Robert Arntfield is making news at his new home, London Health Sciences Center (LHSC) in Ontario, Canada. Dr. Arntfield and his department have s…
Today’s pearl is courtesy of the AM report. When evaluating the lethargic pediatric patient there’s lots to consider. Here’s a mnemonic, that if you can remember it (write it down) could be elucidating. Carbon monox…
A 55yoM is BIBEMS after an MVC c/o RLE pain w/obvious deformity at the thigh. Distally he is NVI but is in excruciating pain. The portable plain film shows a mid shaft fracture. You order dilaudid but he’s still really uncomfortable….
A pleasant 64yoM w/NIDDM and afib (on coumadin) p/w an abscess to R-medial thigh. He is afeb but there is some surrounding erythema at the abscess site. You perform a thorough incision and drainage and instruct him to return in 2days for wo…
A young woman is BIBEMS to your trauma bay. She has been assaulted, has multiple signs of trauma with a GCS of 6 and saliva is noted to be pooling in her mouth and onto the bed. After a swift and successful intubation you further assess the…
A young woman presents with a painful wrist, no trauma history. On exam, there is an effusion present, no erythema and tenderness to palpation. She is afebrile. How do you rule out a septic joint? What pathogen should be considered?
