Brief presentations of current topics in Emergency Medicine based upon our senior resident morning reports
Thank you to Dr. Pearsall for today’s Morning Report: Reversing coumadin-associated ICH: PCC vs FFP Vitamin K for sustained reversal of vit-K dependent coag factors (10mg IV slowly) Oral anticoagulant therapy increases degree of bleeding, with mortality > 50% PCC: inactive vit-K dependent coag factors (II, IX, X Read more…
Today’s Morning Report is courtesy of Dr. Benson: “I think I (k)nee-d some help” 42 y/o M presents for right knee pain and swelling, occurring for the last few days, notably worse today. Differential? Trauma Septic arthritis OA RA Lyme arthritis Gout Bursitis Cellulitis Indications Read more…
Here’s a Morning Report from Dr. Julie on Hemolytic Uremic Syndrome: HUS Cause EHEC (Shiga toxin-producing enterohemorrhagic E. coli) 70% of US HUS cases 0157:H7 (Most US cases) O104:H4 (Germany last yr) 0111 (Australia and US) Shigella (Shigella dysenteriae type 1) India, Bangladesh, and southern Africa Read more…
Here’s Dr. Caputo with an overview of the presentation, diagnosis, and management of Fournier’s Gangrene: FOURNIER’S GANGRENE Rapidly progressing necrotizing fasciitis involving the perineal, perianal, or genital regions and constitutes a true surgical emergency with a potentially high mortality rate (15-50%) The rate of fascial necrosis has been noted to be as Read more…
Today’s Morning Report was originally presented by Dr. Tan on 5/7/2012: Left Ventricular Assist Device (LVAD) Indications: New York Heart Association class 4 heart failure Ejection fraction <25% VO2 max less than 15 among other criteria How does it work: Bypasses left ventricle function. External pump unit outside body Read more…
Thanks to Dr. Yeo for today’s Morning Report on Acute Angle-Closure Glaucoma! Acute Angle-Closure Glaucoma Introduction: Ocular emergency caused by sudden/increase in IOP Prolonged increased IOP may lead to optic nerve damage and irreversible blindness Iris is pushed or pulled anteriorly to block trabecular meshwork, blocking outflow of aqueous, leading Read more…
The following is a case presentation courtesy of Dr. Lau: 56 yo M h/o DM, HTN, previous cocaine abuse, CHF (EF 15-20%) presents with mild shortness of breath and chest pain. Initially, vitals BP 105/62, 85, 20, 98%. Patient not in distress but was walking about ED and complaining Read more…
Thanks to Dr. Pearsall for this review of the clinical pathways to diagnosis of lower extremity DVT! Dx of Suspected 1st LE DVT Tools to Dx DVT: Wells Prediction Rules D-dimer 2-point proximal compression US Whole leg doppler Venography Basic Pathway to Dx: Determine pretest probability Use Read more…
Thanks to Dr. Melendez for today’s Morning Report (originally presented on 4/24/2012)! Venous Access in Neonates A continuation of my case from 2 weeks ago: A mother brings her 9 day old infant in because “she has not urinated in the past 12 hours and she is very sleepy”. Read more…