By Dr. Brenda Oiyemhonlan The last Health Policy Mini-Fellowship meeting discussed “safe harbors”, which can be defined as a set of clinical guidelines that define negligence and appropriate care in the ED. While safe harbors can protect ER docs from medical liability, they have the unintended consequence of attempting Read more…
Dr. Muhlfelder presents today’s Morning Report! SCOMBROID The “seafood allergy”/ Histamine Toxicity Significantly underreported-misdiagnosed as seafood allergy Contaminated dark meat fish i.e. tuna, mackerel, skip-jack and bonito (name derived from Scromdroidea class of fish initially associated with illness) Less likely, but reported: mahi mahi, swordfish, sardines, salmon AND contaminated Read more…
The Teaching Mini-Fellowship met on 8/14 for our first meeting this Academic year. We had two new members join us, Andrea Ferrari and Carla Sterling. They both performed their initiation 5 minute lecture about topics they are experts in. Anyone else who wishes to join us for discussions on teaching methods, Read more…
A 22-month-old boy presents to the ED with his parents following 4 days of vomiting and diarrhea. The parents report that the child has not been playful and has had decreased wet diapers. The mother reports that the child is drinking small amounts, but is vomiting 4-5 times per day. Read more…
Here’s Dr. Nordstrom with today’s Morning Report! The Case: 69 M with history of HTN and DM presents with 1 day of nausea and vomiting. Pt says he woke up in the morning and after breakfast started feeling dizzy and lightheaded. Vomited 10+ times until he came into ER. Denied Read more…
By Dr. Jacqueline Shibata A 35 y/o with Lupus presents to the ED with 1 day of chest pain…. The worst because, as we all know, systemic lupus erythematous (SLE) is an autoimmune rheumatologic disease that can be deadly in young women. Ask yourself: Is this just a bad Read more…
60 yo M, unrestrained driver in MVA, no airbags, no LOC, no head trauma, complaining of chest pain – midline, reproducible to palpation, worse on moving. VS 120, 96/47, 22, 100% Trauma labs are sent, portable CXR and Pelvis Xray are unremarkable. Let’s say his hypothetical pan-scan is normal. Read more…
Great job, Drs. Liang and Reisman. But the winner is…. Dr. Liang for providing a more thorough reading. The CXR is read as pneumoperitoneum/free air under the diaphragm. Differential diagnoses: perforated viscus – perforated duodenal ulcer, perforated peptic ulcer, ruptured diverticulum Toxic megacolon Surgery (after laparotomy) Peritoneal dialysis Read more…
CLEARING CHILDRENS’ CERVICAL SPINES IS A PAIN IN THE NECK! So, it’s been a couple of years since the blog has discussed cervical spine clearance in children. It’s a notoriously difficult task because the Nexus criteria* and the Canadian C-Spine Rule* (both developed for adults but often applied to children Read more…
Rhythm Nation August 2014 Answer! Best and most thorough and most correct reading goes to… Dr. Freedman! The major clue to this case is the recent or evolving STEMI. In the era of thrombolysis for STEMI, the Accelerated Idioventricular Rhythm (AIVR) or Accelerated Ventricular Rhythm was often seen after reperfusion. Read more…