38 yo M pmh brain ca currently under treatment p/w sob, tachpnea, and diaphoresis. You get an initial lactate 6.0 with a FS of 680. What is your diagnosis?
Ultrasound is quite sensitive in detecting even very small pleural effusions; it has been demonstrated to perform better than chest x-ray and nearly as well as CT scan. In order to assess for pleural fluid, the transducer should be directed…
30 yo M pmh ESRD 2/2 to lupus nephritis on HD p/w sob, tachypnea, and hypertensive not responding to Nitro gtt, lasix, or bipap. what emergent procedure will most likely help this patient?
63 yo F p/w AMS noted as AAOx2 w/o focal deficits. Pt appeared cachetic, thin, dry with following VS BP 148/70, HR 142, T 96.4, rr 20, o2 98%. EKG showed sinus tachy with noted persistent lactate 4-5 despite aggressive IVF and remained AMS…
46 yo F pmh right carpal tunnel release 6 months ago presents with intermittent swelling, pain as in burning, feelings of warmth and cold, and hypersensitivity to right hand worsening over past 6 month. What is the diagnosis ? treatment?
3 month old infant that was born full term, NSVD w/o complications presents with seizure like activity to your ED. Pt is afebrile with normal vitals however lethargic and not actively seizing. Off the blood gas you note a Na of 113. What mu…
26 M pmh sickle cell disease p/w chest pain, sob, fever, and cough. She is noted to be hypoxic, anemic and has new pulmonary infiltrates on cxr. What diagnosis must be considered? A: Acute chest syndrome “Acute chest syndrome i…
28 yo obese AA F pmh sickle cell disease comes in complaining of b/l leg pain similar to her prior pain crises. She states that she normally takes 8 mg morphine IV to control her pain however your hospital has a morphine shortage. Wh…
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…
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…
Welcome new interns across the land! You will be receiving lots and lots of advice from many sources, so I’d like to pour some ultrasound scanning tips into the information deluge. Most of these tips were posted here at SinaiEM.us a f…
The current issue of SAEM’s resident newsletter features an interview with Bret Nelson regarding ultrasound training. He and Beatrice Hoffman, MD, PhD, RDMS (Director of Ultrasound Education for the Department of Emergency Medicine at…
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…
When assessing for a difficult airway what does the LEMON acronym remind us to check? In a study, only three factors from LEMON are associated with a difficult intubation, which are they?
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…
