Author: Nicole Anthony, MD Peer Reviewer: Trevor Cerbini, MD In Part 1 of our 2-part series on hypoglycemia, Erroneous Blood Glucose Readings and Where To Find Them, we introduced the vignette of a patient in a shock state whose peripheral fingerstick reading would not respond to repeated dextrose administration. Now, Read more…
A gentleman presents to the emergency department as a notification for altered mental status. The first thing EMS tells you is that the patient’s blood sugar on scene was 28 mg/dL, so they gave him an amp of D50W with mild improvement in mental status. On your exam, however, the Read more…
Author: Calvin Tan Edited by: Wesley Chan Case: You are the lead physician in the medical tent at the finish line of a single-stage, 24-hour, self-supported, 100-mile race. The only on-course support consists of simple tents every 20 or so miles with first aid supplies and water to refill hydration Read more…
This post is based on Teaching Shifts From Dr Christophe, Dr Taitt, and Dr Berland Case 1: A 24-year-old female with no medical problems presents with abdominal pain, nausea, and vomiting. Her LMP was last week. She denies alcohol use but admits to daily marijuana use. When you peruse her Read more…
Diabetic ketoacidosis (DKA) is seen so often in our ED we may take the diagnosis and treatment for granted. Just follow the numbers – potassium 3.5, glucose 250, insulin drip at 0.1 U/kg/hr. But it helps to understand the underlying pathophysiology, because this can help you form a more nuanced Read more…
Case: It’s your 5th straight night and your pediatric ED shift ends in one hour. A few stable patients came in during your shift, and you’re happy about that. No one wants kids to be sick. Your mind begins to wander. To be honest, the inner fat kid you’ve always Read more…
Case: A 48-year-old man with no PMH presents via EMS with dyspnea and diarrhea worsening over 2-3 weeks. He has attempted to self-treat the diarrhea with loperamide. He also reports generalized weakness, swelling in both his legs, and palpitations. PMH: Questionable COPD – treated once PSH: denies Meds: denies Read more…
Setting the Scene Your patient is a 21 year-old female with a history of type 1 diabetes mellitus who was brought to the ED by her boyfriend for diminished responsiveness. In a stupor, she is unable to give any history. Her vitals are: BP 102/66, pulse 120, respiratory rate 24, Read more…
ED Management of Hypercalcemia of Malignancy Hypercalcemia in the ED is often times an incidental finding. The clinical presentation, management and treatment of hypercalcemia as it specifically relates to malignancy will be discussed here. Workup of hypercalcemia When considering the diagnosis of hypercalcemia, it is important to understand calcium’s distribution Read more…
A young woman’s life was truly saved by the one and only… Dr. Molly Cutright! A 28 year-old woman with no past medical history was brought in by EMS for altered mental status. EMS reported that the patient had “belly pain and was pregnant.” She was moaning and not making Read more…