CAD and ACS: Both HIV and anti-retroviral medications increase patients’ risk of cardiovascular disease HIV-infected patients tend to have a first episode of ACS at age 48 yrs, 10 years earlier than HIV negative patients Reasons for i…
Abducens (CN VI) Nerve Palsy CN VI causes contraction of the lateral rectus muscle, allowing the eye to abduct. An abducens palsy will present with impairment of lateral gaze of the affected eye. Causes of an Abducens palsy include:…
A recent systematic review in Pediatric Emergency Care attempted to identify the most reliable clinical, biological, and radiological signs of ovarian torsion in the pediatric population. Ovarian torsion is a rare but serious cause of abdom…
A 42 yr old male is BIBEMS by his friend after reportedly ingesting an unknown amount of metoprolol 5 hours prior to arrival. In the ED he is hypotensive to 80s, bradycardic to 40s, with decreased mental status. The patient is intubated, a…
An uncommon fracture can be easy to miss, and if you do not look for it, you might not see it. Scapula fractures – Typically seen in association with other injuries in setting of major trauma, but may be missed in the patient with sho…
In patients with not immediately life-threatening blunt chest wall trauma, it can be difficult to decide which patients may require hospitalization and which patients can safely return home. A systematic review assessing risk factors for mo…
The terminal R in AVR can be seen with any significant ingestion of a sodium channel blocking agent (including TCAs). Sodium channel blocking agents work by delaying phase 0 (upward stroke) of the myocardial action potential. This leads to…
Cervical artery dissections include carotid or vertebral artery dissections and can be seen in patients of all ages, although they are a more common cause of stroke in young patients Symptoms may be somewhat non-specific (headache, n…
A 19 yr old male with a history of depression presents to the ED with diffuse, worsening rash, arthralgias and fever for the past 2 days. The patient recently started taking bupropion over the past 3 weeks and also started venlafaxine last…
Patients with connective tissue diseases and vasculitides can present to the ED with vague or seemingly innocuous complaints but may actually have a life threatening condition. Key conditions to assess for include: 1. Septic arthritis in th…
Liver cirrhosis is associated with hematologic derangements which can cause both coagulopathic and prothrombic states. However, it is less clear whether liver disease truly increases patients’ risk for intracranial hemorrhage (ICH). A…
Drowning is defined as “the process of experiencing respiratory impairment due to submersion/immersion in a liquid.” Pathophysiology: Drowning occurs as the patient’s airway is submerged below water. Initially, the…
Hypertrophic cardiomyopathy Genetic condition usually due to mutations in one of several sarcomere genes causing LVH and potentially LV outflow obstruction, diastolic dysfunction, mitral regurgitation. Patients may present with CP, dyspnea,…
A single-blind, randomized clinical trial of ED-initiated palliative care consultation for patients with advanced cancer showed a significant improvement in quality of life as measured by a change in the FACT-G score at 12 weeks. Median sur…
Both subxiphoid and parasternal approaches have been used for emergent pericardiocentesis in patients presenting with pericardial effusion and tamponade, but which approach minimizes procedural complications? In a 2012 review by Clinical An…
