It’s 15 minutes from change of shift, and you are recovering from a busy overnight in the critical care area of the ED. Suddenly, an intubated patient rolls in the door without prior notification, and EMS is performing chest compressions. “Intubated… three rounds of epinephrine and one round of bicarb Read more…
Digitalis, a cardiac glycoside, is an age-old drug used since the time of the Romans. It wasn’t until the 18th century when the study of digitalis propelled humankind into the age of modern medicinal therapeutics. The cardiac glycosides are isolated from the foxglove and were espoused by William Withering, a famous Read more…
Not a lot of takers on this tough ECG. Here’s some insight. Initial ECG: Sinus tachycardia, LAD, 1st degree AVB, RBBB Repeat ECG: NSR, LAD, 1st degree AVB, RBBB, TWI in V4-V6 A Closer Look At The Case Our patient presented with a worsening headache with associated altered mental status. Read more…
It’s Friday night, and you get a second in between patients. You are dreaming of sipping a Mai Tai by the beach, when your dream is quickly brought to an end. A 35-year-old young man walks into the ED, complaining of an episode of “passing out” after a few drinks. Read more…
I’d like to thank our 4th year resident, Dr. Michael Griesinger, for essentially giving me this entire lecture in real time as he diagnosed and treated an inferior STEMI with right ventricular (RV) infarction yesterday. He nailed every aspect of it. Everything I researched today was just confirmation. So let’s talk about RV infarction. When should I worry Read more…
This month’s excellent save goes to… Dr. Steven Greenstein! Dr. Greenstein was working during a particularly busy shift in the Critical Care / Trauma area when EMS brought in a patient with a history of prostate cancer and a chief complaint of shortness of breath. Triage vital signs were notable Read more…
What if you woke up in a hospital and found out your mortal enemy had surgically removed your face and glued it onto his own and now he was out in the world pretending to be you? Living your life, hanging with all your friends, doing all your drugs, having all your fun? You’d Read more…
A 72 year-old female presents to your ED for excruciating, “10/10” left leg pain. Patient states that the pain awoke her from sleep two days ago, but she never went to the ED because she hates doctors. She states she’s having trouble moving her left leg now, and family members noticed it Read more…
A 52-year-old man with diabetes, hypertension, end-stage renal disease on dialysis, and CAD presents to the ED with sudden onset of shortness of breath. He endorses missing his last dialysis session because he left the country for a week and was forced to pay for his last session out-of-pocket in Read more…
It’s 4 AM. CCT is empty. You are doing uWorld questions for your upcoming Step 3. As you are about to drink your warm, cheap coffee, the triage nurse rolls in a 39-year-old female with no significant PMH who is complaining of shortness of breath. The patient notes worsening dyspnea Read more…