It’s 1993. You are doing a month of elective in Bogotá General Hospital in Colombia. It’s your first week, and you are eating the empanada you got on the street. You turn on the TV: “A HUGE CAR BOMB KILLS…
Bored and Burnt – Inhalation Injury
Too Cute To Be Bored: Acute Chest Syndrome
It’s a beautiful day outside, and the pediatric ED is packed with super cute, snot-nosed children. While you are busy at work, you are happy that all of these kiddos are so adorable. You are wondering if your shift can…
So Bored Sour Salivary Stones
It’s another long night in pod A, but luckily there is a break in the unending stream of patients. You head to your favorite green delicatessen and feeling adventurous, you pick up a bag of sour candy. So sour! Your…
Let’s do some introspection: PTSD among emergency providers
There’s no ‘normal’ day in the Emergency Department. It’s a matter of pride that as a group, we’re all highly adaptable and energetic enough to handle anything that comes through the door at any moment. It’s never boring. It’s an…
EM-Critical Care: Listen to the Bass Go Boom…
The Case: A 20 year-old male h/o DM was found down and unresponsive after a gas explosion downtown with agonal respirations and extensive burns to anterior trunk, right upper extremity and bilateral lower extremities. Vital signs were BP 150/92 HR…
Brainstem Rule of Fours
Who remembers the brainstem in medical school? You vaguely remember pictures like the one to the right that made you want to adopt a pug? Well, stick with me and let’s learn a system for the brainstem. I promise I…
Syncope – Not for the Faint of Heart
Dr. Sinert graciously hosted Food & Journal this week at his outdoor courtyard in Brooklyn. Over barbecue and veggies, we spent the first half of the night discussing a new paper on syncope management and the second cheering Usain Bolt to…
A Ripping Pain
A 67 year-old male with history of hypertension, diabetes mellitus type II, dyslipidemia presents to the emergency department with 1 hour of severe chest discomfort that started while he was watching the evening news at home. The chest discomfort is…
An Ultrasound from the Peds Side!
A 12 year-old female with no PMHx presents to the pediatric ED with acute-onset crampy and sharp left-sided pelvic pain. The pain started 3-4 hours earlier, associated with nausea but no vomiting or diarrhea. VS: HR 102, BP 110/86, T: 99.4…
An Asymmetric Chest X-ray
A 65 year-old male presents with a worsening productive cough, shortness of breath, general malaise, and subjective fevers and chills for the past week. His PMHx includes HTN, CAD, and DM. He has a 30 pack-year smoking history. He has…
Tox: Sweet talk & slurred speech
About halfway through your relatively quiet shift in the Critical Care & Trauma area of your ED you hear an overhead notification, “stroke code to triage!” You and Padma the intern set down your tasty cappuccinos and speed walk…
Morning Report: Tachycardia-Mediated Cardiomyopathy
You are sitting in the Critical Care area of your ED and the walk-in triage nurse approaches you with an ECG and a patient. She tells you he is a 60 year-old male with a PMH of cardiac stents presenting…
Case of the Month 13 – Answer
Rhythm Nation: August 2016 ANSWER
Good job, Eden Kim, for correctly Identifying pulmonary hypertension on EKG!! Let’s talk about pulmonary fibrosis and pulmonary hypertension and their prominent electrocardiographic findings. Idiopathic Pulmonary Fibrosis History usually >50 years old progressively worsening dyspnea and non-productive cough history…
So Bored…Eye started Crying II
Welcome back. We’re going to continue reviewing common eye complaints. This time we’ll focus on the conjunctiva. Let’s quickly review. The conjunctiva is a thin, clear lining that covers the anterior portion of the eyes and eyelids. …
VBG vs ABG in Hypercarbia
The blood gas analysis offers important data to guide the treatment and prognostication of critically ill patients. Providers are able to quickly assess acid-base status, tissue perfusion, and respiratory mechanics. Traditionally, providers relied on arterial blood gas (ABG) for these…
Case of the Month 13 – Presentation
An 83 year-old female comes to the ED with burning epigastric pain, worse with an empty stomach, non-radiating, and non-exertional. It is not associated with nausea, vomiting or diaphoresis. She has not tried any remedies at home, but nothing makes…
How good is your Cartwheel?…Wait, your what? – Stages of Learning
So Bored I Broke My Hand – Metacarpal Fractures
It’s 8AM. You are done with your night shift. All you can think about is a toasted whole wheat bagel with cream cheese and hot cup of single origin, organically grown, locally brewed and roasted cup of coffee.…
Possessed? no bored – Review (Anticonvulsant Overdose)
Wrapping up your secret interpretive dance class, you realize that the teacher is looking awfully slow. You approach him, and before he falls into your hands in his sweaty silver spandex, he tells you that his dancing is inspired by his seizure disorder. He…
So Bored I had a Blue Leg (DVT Emergency)
You have just come home from an exhausting 12- (really 13) hour shift and left with the final two perpetual decisions residents must face before sleep: What to eat? Watch Netflix or study? Both choices are easy. As the water…