An in-depth analysis of current topics in Emergency Medicine and Critical Care Medicine typically based upon our regular EM-CCM conference.
by Peter Tepler, MD A 40-year-old woman comes to the hospital by taxi. After reporting severe headache, the triage nurse notices that she is garbling her words and immediately takes her to the stroke assessment area and grabs you. Her ABCs are all intact. Patients triage vitals are: HR: 84/min Read more…
“He took all his medication,” you chuckle to yourself as you read the chief complaint on the board. “Man, isn’t that what we try to get all our patients to do?” As you open up the patient’s chart, however, your smugness quickly turns to unease when you read through the triage Read more…
This EM-Critical Care Medicine case presentation focused on a very complex resuscitation with multiple facets. The case is notable because it includes most, if not all, of the factors we should consider when worrying about a peri-intubation arrest. Let’s recap the initial case and apply what was learned in conference Read more…
It’s a quiet night in the critical care area of the ED, and you are engaging in stimulating and academic discussion with your attending and junior resident about the merits of cinema in the 1980s. Just as you broach the subject of Steven Spielberg’s ET the Extra-Terrestrial, the red phone Read more…
The Case 50-year-old woman is brought in by EMS after intentional ingestion of her 500 mg extended release valproate in a suicide attempt approximately 40 minutes prior to arrival. She had recently filled her valproate prescription with 80 tablets and took nearly all of them. She admits to feeling depressed 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…
Emergency Department Management of Spontaneous Human Combustion Written by Adam Blumenberg, MD
Thoracic Aortic Dissection A difficult to diagnose, uncommon, and potentially fatal condition: Emergency Medicine at its finest! Let’s talk about a patient we think see every day in the ED. A man comes in complaining of chest pain with elevated blood pressure of 200/90 upon triage. The ECG shows sinus Read more…
29 year-old male arrives as a trauma notification. EMS states patient had a single gunshot wound to the mid-chest with vitals as follows: HR 120, BP 90/50, RR 22, SpO2 95%. The patient is mumbling incoherently with spontaneous eye movements and is reacting to pain. As the trauma Read more…
Case: A 77 year-old male h/o asthma, HTN, HLD, recently diagnosed CML presents with pain to recent bone marrow biopsy site and right lower extremity pain such that he cannot walk since last night. He also c/o nausea with few episodes of NBNB vomiting. He was prescribed imatinib but has not started Read more…