An 18 year old female presents to the ED with vague symptoms of lower back pain. She exhibited inappropriate and erratic behavior that seemed more than just teenage angst. The patient was thin in NAD and had a grossly normal musculoskeletal…
You obtain a venous blood gas (VBG) on a patient with a COPD exacerbation because you are concerned about hypercarbia. You get a value of 55 mmHg. How correlative is that compared to an arterial blood gas (ABG)? A small study (n=89) publish…
How do I interpret WBCs in a traumatic tap?
PE in Pregnancy
Ketofol, Propofol, or Ketamine + Propofol? In a recent study published in Annuals of Emergency Medicine, Ketofol (1:1) vs. Propofol alone were studied for ED procedural sedation and analgesia. The two agents were compared for adverse respir…
A 60 yo F with sudden onset loss of vision in right eye, painless. Proceeded by a few episodes of amaurosis fugax. Physical exam: pupils appear normal on initial inspection, however afferent pupil defect noted. Fundoscopic exam: cherry red…
55 Chinese woman, no PMH, no meds. P/w epigastric discomfort x 2 weeks, not responding to Pepcid Maalox. Presented to Elmhurst ED for worsening epigastric discomfort and generalized weakness. No fever/chill. + Mild dry cough. No chest p…
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 previously healthy young patient presents to the ED with sudden onset headache followed by progressive and profound altered mental status. You rush them to radiology for a head CT, which shows a large subarachnoid hemorrhage. Upon return…
A 66 year old female patient presents to the ED with a transient episode of dizziness and SOB earlier today. PMH notable for stage III CKD, DM, HTN. She takes valsartan, metformin, and is currently on TMP-SMX (Bactrim) for a UTI. Her EKG sh…
A 50 year old patient with HIV, HCV cirrhosis presents to the emergency room with subjective fevers and generalized abdominal pain with tenderness. As part of your workup, you plan for a diagnostic paracentesis. On ultrasound imaging, the p…
A young lady is brought by friends on a makeshift stretcher. They have leaves in their hair and look frantic. They report that the patient went behind a tree to urinate, while on a hiking trip, and screamed after being bit on her L-forearm…
How does kayexalate work? Is it useful in the ED?
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…
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…
