Authors: Taylor Douglas; Naomi Rebollo Rodriguez Edited by: Nicole Anthony; Wesley Chan Many patients present to the Emergency Department (ED) with the chief complaint of shortness of breath. There are myriad causes and extensive treatments available. However, what about the patient who has dyspnea because they have a terminal illness 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…
It’s another day at your local university hospital. You’re nearing the end of your shift and wrapping up your cases. Your mind is already starting to wander with thoughts of what you’ll do on vacation. Suddenly, you hear some commotion stir through the ED — TRAUMA CODE to the hospital Read more…
They were fine yesterday, now they’re drowning! “Flash” (acute) pulmonary edema is a common critical condition in the emergency department, and it can have multiple precipitating factors and etiologies. After evaluating for acute myocardial infarction, tachydysrhythmias, and valvular pathologies based on physical exam and ECG, the treatment for these Read more…
A young woman presents to your ED with shortness of breath and pleuritic chest pain. She states she got off a long plane flight from the Philippines. She is mildly tachycardic. OK, you think, let’s just whip out the ol’ Well’s criteria and get to work. You pull up her Read more…
Check out the original post here: Xray Vision: Chest Pain Congratulations Dr. Grundmann! This patient has a primary spontaneous pneumothorax. References: Humphries RL, Young W, Jr.. Chapter 71. Spontaneous and Iatrogenic Pneumothorax. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY: McGraw-Hill; Read more…
Dr. Grock presents today’s Morning Report! Pulmonary Infections CAP If no abx in last 3 mo and healthy: A Macrolide (2nd line Doxy) If chronic heart, lung, liver, renal disease, DM, ETOH, Ca, Asplenia, Immunosuppressed, or abx use in last 3 months: Resp fluoroquinolone, B-lactam + Macrolide If Read more…
Here’s a Friday the 13th edition of Morning Report presented by Dr. Waldman! The Case: 42 yo F hx of asthma, heavy smoker p/w 3 days of wheezing and SOB. Pt had been admitted for asthma in the past but never intubated. Albuterol and ipratropium were not helping at Read more…
EM-Critical Care Conference: August 2013 PULMONARY EMBOLISM Summary by Dr. Eugene Kang Diagnosis and EKG: -Most common EKG finding: non-specific ST-T changes (at least for our boards) -Other findings: sinus tachycardia, complete or incomplete RBBB, RAD, right atrial enlargement, dominant R in V1, atrial tachyarrhythmias -Some likelihood ratios (see Read more…
Thanks to Dr. Grock for today’s Morning Report! The case: 20 yo male no pmhx, presents with pleuritic chest pain, dizziness, and worsening DOE x 3 days (class IV). No fevers, no toxic habits, no travel/sx/immobilizations/hx dvt or pe. VS: tachycardic to 110s (up to 130s with minimal exertion), Read more…