Welcome to Save of the Month! where each month we recognize a resident who went above and beyond to make a great save in the ED. Nominations are solicited from the faculty each block and we pick one resident for recognition and embarrassment on this blog.
This month’s edition goes to . . . Dr. Emad Shabana!
Here’s the story . . .
50yo M with PMH of Atrial flutter on coumadin, CHF with EF 5-10%, CAD w/stents who presented with chest pain, shortness of breath and left arm pain and numbness after raising arm in the shoulder. Easy admit for ACS, right?
Emad did an excellent physical exam, picking up that the patient had decreased pulses and a cool hand.
It turns out, the patient had a TEE that showed a left atrial appendage. He was only taking half his prescribed dose of coumadin.
Vascular surgery was immediately paged. They took the patient to the OR for embolectomy. A large proximal brachail artery thrombus/embolus was removed with return of good pulses to the distal arm.
It would have been easy to just admit this patient for chest pain/ACS, but a good physical exam likely saved this patient’s arm. Good job Dr. Shabana!
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Jay Khadpe MD
- Editor in Chief of "The Original Kings of County"
- Assistant Professor of Emergency Medicine
- Assistant Residency Director
- SUNY Downstate / Kings County Hospital
Latest posts by Jay Khadpe MD (see all)
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1 Comment
Ian deSouza · July 15, 2014 at 11:24 am
Great job, Shabana. I would bet at least 75% of the department (all levels) would have missed that. (Feel free to admit the patient for IT, but IT’s almost never “ACS”. Don’t half-ass your History (most important) and Physical or you will miss things.)