A 65-year-old woman presents to your ED complaining of pain in her left eye. She says that she was walking past a construction site and suddenly felt left eye pain. She says that she cannot see out of her left eye at all and is very concerned. What is the Read more…
What is the prevalence of PE in patients who present to the ED with syncope? (This is part 2 of a two-part series.) In our last post, we discussed four studies that attempted to describe the prevalence of pulmonary embolism in ED patients who have experienced syncope. In this post, Read more…
What is the prevalence of PE in patients who present to the ED with syncope? References 1. Prandoni P, Lensing AWA, Prins MH, et al. Prevalence of Pulmonary Embolism among Patients Hospitalized for Syncope. N Engl J Med [Internet]2016;375(16):1524–31. Available from: https://doi.org/10.1056/NEJMoa1602172 2. Oqab Z, Ganshorn H, Sheldon R. Prevalence Read more…
(By David Warshaw, PGY2 and Naomi Rebollo, PGY3) 7:05am – This is our first patient of the day on your first CCT shift as a senior… 56-year-old female with shortness of breath x a few hours You quickly scan through her chart and notice a diagnosis of pulmonary hypertension. Read more…
In a previous post, I presented a case of Takotsubo non-ischemic cardiomyopathy that met “STEMI” criteria and was diagnosed by angiography. Let’s take a moment to discuss some other non-ischemic cause of ST elevation, otherwise known as “STEMI mimics.” 1) Benign Early Repolarization and Left Ventricular Hypertrophy ST-elevation does Read more…
The theme for October Food and Journal Club was Geriatric Emergency Medicine, hosted by our guru of Geriatric EM (and my mentor for residency and geriatric mini-fellowship) Dr. Joel Gernsheimer. Also in attendance from the faculty side was one of our other Food and Journal Club veterans, Dr. Sinert. We Read more…
Thought Experiment: Applying an EBM Disease Model to Defensive Medicine But, if a lawyer were to review your chart, how would you defend that decision? We have all had attendings say this to us when we present a plan for a patient, perpetuating the next generation of defensive medical practitioners. Read more…
Editorial preface: I will be occasionally using the term occlusion myocardial infarction (OMI) to signify acute coronary occlusions which should be emergently reperfused (thrombolysis or percutaneous coronary intervention). Unfortunately, as OMI inherently does not have ‘false negatives’, I will still begrudgingly include the phrases ACS and STEMI as many are Read more…
A 50-year-old woman with no significant past medical history is brought to the ED via EMS as a “STEMI notification”. As per family, the patient was at the post office when she developed sudden onset chest pain and then syncopized. The patient had not seen a doctor recently and does Read more…
It’s a hot summer day in Brooklyn, and you’re working in the pediatric emergency department. EMS brings in a 7-year-old boy who fell off his bike. You can see a large laceration on his right arm. X-rays show no fractures or foreign body. You control his pain, but the kiddo Read more…