The notification phone rings: “Cardiac arrest, intubated, ETA 3 minutes.” Take a breath. You look around and notice you have a loaded team! EMS rolls in and moves that patient to the stretcher. Your awesome nurses get IV access on the first try while you promptly assemble the LUCAS device Read more…
This article is reposted from The American Journal of Emergency Medicine. Introduction The coronavirus disease 2019 (COVID-19) pandemic has caused a total of nearly 300,000 deaths worldwide [1]. Pediatric patients PCR-postive for SARS-CoV-2 present differently than adults with 40% either asymptomatic or with URI symptoms and commonly have pharyngeal erythema Read more…
Note: The cases discussed in this post happened before COVID-19. Given that D-Dimer may be elevated in patients with COVID-19, the pretest probability of PE in your patient population may be elevated at this time. Thus, the assumptions derived from Kohn et al’s paper highlighted in this post may not Read more…
Which aortic dissections need surgery? Although it is not the ED team’s decision whether to take a patient with dissection to the OR, it is vitally important for us to be familiar with the indications, so we can effectively advocate for our patients as needed. Management of aortic dissections differs 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…
This article will not attempt to wade into the pathophysiology of acid-base disorders. From reading the nephrology literature, it seems that this topic is more closely akin to theoretical physics than the sturdy biochemistry I learned in college. Researchers can’t even agree on how to define acidosis, much less what Read more…
We had only one response to this most recent edition of Case of the Month, and Dr. Birnbaum hit the nail right on the head. Check here for the complete vignette. To summarize: The patient is a 28-year-old man with a history of systemic lupus erythematous with numerous complications, and 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…
Get your thinking caps ready folks, for it’s time for the newest edition of Case of the Month. The patient is a 28-year-old man with a history of SLE complicated by lupus nephritis, who presents with pressure-like mid-back pain since last night. He experienced no relief with oral Read more…