Month: March 2016

Bored and… MOONWALK!

  It’s a beautiful night in the ED in 1986. Bad fashion is in, EM docs are still cowboys who heal the world, and yours truly is about to be born. Most importantly, Michael Jackson is performing in your city…

Refractory Shock

It’s a busy night shift when a nurse alerts you to an elderly patient sent from a nursing home who is hypotensive, tachycardic, tachypneic, febrile, altered, and appears dehydrated.  You assume sepsis, send labs, begin treating empirically with broad spectrum antibiotics, and…

Palpitations and Valvular Disease

The Case 58 year-old man with history of mitral valve prolapse presents with 4 days of intermittent palpitations, lightheadedness, and shortness of breath. The symptoms resolve spontaneously. He denies any illicit substance use. Vital signs on arrival: T 97.5F, HR…

Was Bored so Took Too Much – Review

  A 60 year-old aging death metal uber-fan walks into the ED crying, saying that he just tried to commit suicide. When you inquire further, he tells you that he is still sad about Iron Maiden breaking up. He hasn’t been the same since…

Case Of the Month 8 – Answer

Eden Kim gets the nod for last month’s COtM answer not only for getting the correct diagnosis, but also expanding his discussion with a very solid differential diagnosis list. Congrats Dr. Kim!   Here is a one-line summary of the…

Abdominal Compartment Syndrome

By: Yonatan Yohannes, MD Abdominal Compartment Syndrome Who: The critically ill. Most commonly in shock, burn patients, polytrauma patients.   What: Primary -> abdominopelvic disease/injury: trauma, pancreatitis, surgery, etc. Secondary -> conditions originating elsewhere: sepsis, burns   When: Normal IAP…

Bored into a Nosebleed – Review.

A 19 year-old patient presents to your ED with a nosebleed. His friend states they were in the bleacher seats of an anime convention when he became so aroused that his nose just started gushing blood. He’s been bleeding for about 30 minutes…