Samwise Gamgee presents to your Emergency Department after an ankle injury. He was in the Mines of Moria when a flock of bats flew all around him and he fell, twisting his ankle. He doesn’t think he got any bites or scratches from the bates. He is ottowa ankle negative Read more…
TPA for MI when PCI is not available – recommended so thoroughly it’s in textbooks. TPA for clotted AV fistulas – surgeons do it. TPA in stroke…not going anywhere near it. TPA for PE…Interested? After a lit search [1] done under the tutelage of Dr. Shahriar Zehtabchi, here’s Read more…
Physical exam: Hypertension can be seen in 50% of the patients and can be due to catecholamine surge. Hypotension (in 20% patients) can be a result of excessive vagal tone, cardiac tamponade, or hypervolemia from rupture dissection. References: Mancini, M. Read more…
On February 11th, we will be presenting a thorough analysis of the following New England Journal of Medicine paper: Ultrasonography versus Computed Tomography for Suspected Nephrolithiasis by R. Smith-Bindman, et al. Click here for the article Possible questions to comment on and/or ponder: 1. Does this paper change my Read more…
Whew! We made it to the last week of Environmental Emergencies. I thought that it would never end. A terrified government worker who frequently receives threatening mail with strange powder in it presents with a rash accompanied by fever. The rash has been present for 4 days. What features of Read more…
Bad things happen. Trauma and tragic illnesses take the young and old. The world is not kind or just. And we, emergency docs, work at the intersection of daily life and tragedy. We strive to mitigate illness and injury. But often we can’t. We’ve all seen tragedies and monsters. And Read more…
Congratulations to both responders who weren’t fooled for a second! This month’s winner is Dr. Nico Grundmann with honorable mention to Dr. Brenda Oiyemhonlan! Onto the ECG A bifascicular block with a possible (i.e. incomplete) underlying trifascicular block. What makes it “possible” instead of definite? Clear evidence of Read more…
65 year old male presents with chest pain. He describes the pain as “pain”, but radiating to the back. Denies shortness of breath, nausea, or diaphoresis. You decide to get a CXR…and you see: please provide a read. What would you do for the patient?
Here’s Dr. Adal with today’s Morning Report! Peritonsillar Abscess Differential Diagnosis: Tonsillitis, Pharyngitis, Epiglottitis, Paratonsillar Cellulitis, PTA, RPA, PPA, Diptheria, Ludwigs angina, Uvulitis, Mononucleosis, Acute HIV, Carotid Aneurysm. Epidemiology: Most common deep space infection of the neck. Young adults in winter and early spring. Pathogenesis: Polymicrobial Read more…