Chika-what? The CDC recently sent out an alert (June 17th, 2014) to healthcare providers regarding the outbreak of the infection caused by the chikungunya virus in multiple Caribbean countries (http://wwwnc.cdc.gov/travel/notices/watch/chikungunya-caribbean). The chikungunya virus is an RNA virus that was originally described in infected individuals in Tanzania, but outbreaks have been found in Asia, the Indian subcontinent, […]

A three month old male presents to the pediatric emergency department with his mother who reports patient has been constipated recently, his last bowel movement was five days ago.  She reports he has also been had decreased appetite and PO intake.  No vomiting.  No obvious pain complaints.  He appears generally weak to his mother.  His […]

A patient presents to you from a nursing home, with paperwork stating that her G tube fell out this morning as her nurse was attempting to give her her daily medications.  What further information do you need to know, and how do you proceed?

A 33 year old male Riker’s inmate presents to the emergency department after corrections officers report that he was observed to have jumped off a chair in his cell, with a bed sheet tied around his neck.  Per officers, they were able to cut him down after approximately 1 minute of him being partially suspended. […]

A mother runs into the pediatrics emergency department, clutching her 10 month old daughter.  She states her daughter had been drinking from her bottle at home and then stopped drinking, turned purple, and became limp for ten seconds, and then started crying.  Her daughter is still crying now, moving around in her mother’s arms.  Vital […]

As emergency physicians, we have all noticed that the number of geriatrics patients that visit the emergency department continues to increase over time.  It is projected that by 2013, 20% of the population will be age 65 or older.  One important issue with respect to geriatrics patients is inappropriate prescription/use of medications.  Data shows that […]

Your patient is a 35 year old male who presents with right hand laceration, he states he was reaching blindly into a drawer of utensils, and cut the volar aspect of digits 2-5.  The laceration appears deep.   How do you assess for ligament and tendon function in the fingers/hand?  

A 30 month old female is brought to the emergency department by her 16 year old babysitter.  Her babysitter states the patient was vomiting in the living room of her (the patient’s) home.  When asked about her story further, she admits that she had left the patient alone in the living room, and that saw some pill […]

  Peri-intubation oxygenation and maintenance of adequate alveolar saturation is vital to patient safety.  Desaturation below 70% during intubation places patients at risk for hemodynamic decompensation, dysrhythmias, cerebral ischemia, and death.  The Emergency Physician must secure an endotracheal tube rapidly and prevent critical hypoxia. Important considerations include: 1.  Choice of agent: Studies have shown Rocuronium prolongs time to desaturation when […]