Written by: Raymond Beyda For the non-emergent, non-ketotic, non-acidotic, uncontrolled hyperglycemic… Case: A 47 yo M h/o DM with frequent ED visits presents feeling dizzy and lightheaded x 3 days. ROS is positive for polyuria and polydipsia. Vital signs are within the normal range, his exam is unremarkable. Imaging is negative. Read more…
This month’s critical care mini-fellowship discussion was about the article, “Timing of Vasopressors in Septic Shock” as well as a review of the recent PROCESS, ARISE and PROMISE trials. Overall mortality rates in septic shock improved significantly from the 1990s to 2012 which coincides with several changes of practice including the Surviving Sepsis Campaign Read more…
It wasn’t too long ago that I reviewed pulmonary infections for a morning report (see summary here). We reviewed some fun facts including: – 10 % of HCAP have atypical infections indicating the use of Azithromycin. – For outpatient CAP treatment, IDSA recommends Azithromycin (other option being doxy) – For Read more…
I had wanted to write on the utility and interpretation of serial CBCs. I do it all the time and I’m sure my practice is not well-informed. However, it’s doing. It’s active. And we love doing. (Check out Drs Sinert and Zehtabchi’s paper1) Speaking about doing, yesterday I was Read more…
Presented by: Dr. Niccole Bart Summary by: Dr. Kaycie Corburn The Case: 70 year old female with a long past medical history including a previous heart block with a pacemaker placed 20 years ago presents to the ED following a witnessed VF arrest with ROSC in the field within 5 minutes of Read more…
Dr. Grock presents today’s Morning Report! Case: 32 F 18 wks by LMP presents with chest pain: sharp, non-exertional, 7/10, mildly decreased ET, bilat LE edema. VS HR 102, BP 130/74, RR 20, Temp 99.8 oral, O2sat 98% on RA. What are you worried about? PE? MI? Let’s start Read more…
Presyncope is a poorly studied symptom. Often practitioners dismiss it or treat it like a full syncopal event, but until recently what the risks are in this population of patients in the ER was not well known. Do you want to know what the best study to date shows on the Read more…
Here’s Dr. Wang with today’s Morning Report! Ingested Foreign Body Foreign bodies can be anywhere in the entire GI tract. The esophagus has three areas of narrowing where foreign bodies are most likely to become entrapped upper esophageal sphincter (UES) crossover of the aorta lower esophageal sphincter (LES) certain Read more…
Thanks to Dr. Kincade for today’s Morning Report! Wellens Syndrome Pattern of inverted or biphasic T waves in precordial leads that are specific for critical LAD stenosis Critical stenosis LAD High risk of anterior MI w/o medical tx: 75% pt advance to ant MI in avg 8.5 days Read more…
Here’s Dr. Alsup with today’s Morning Report! Hip Dislocations *Dislocations and fracture-dislocations are true orthopedic emergencies History: ABC’s: This injury is a red flag for multisystem injury Associated injury (95%) Assoc acetabular fracture 70% Knee fractures/ligamentous injury/ dislocation 30% Sciatic palsy 10% of patients (peroneal nerve branch) Read more…