Author: Philippe Ayres, MD Editor: Galina Udod, MD Case: A 33-year-old female presents to an ED after being extracted from a car that was in a front-end collision with a truck. On primary survey, the patient opens her eyes spontaneously and squeezes her hands and moans to command. The patient Read more…
Author: Nicole Anthony, MD Editor: Alec Feuerbach, MD A few years ago, I had a patient, a young woman, who had just immigrated to New York from Libya. She had left her family behind, and her only contact in New York City was the family friend with whom she was Read more…
Author: Karen Jeoffroy, MD Editors: Philippe Ayres, MD and Alec Feuerbach, MD Case: A 27-year-old G2P1001 female, six weeks pregnant by LMP, presented to the ED with two weeks of worsening nausea and vomiting, vaginal bleeding, and mild, intermittent abdominal cramping. She reported a positive home pregnancy test; however, Read more…
Author: Harry Nonez, MD
Edited by: Nicole Anthony, MD
You are a senior resident working in the critical care area of a busy ED. You are juggling eight patients, and the triage nurse pulls you aside to evaluate another one. The patient is a 35-year-old woman at 37 weeks gestation who is presenting with a severe headache and acute abdominal pain. She had a routine prenatal visit four days ago at which she was asymptomatic, and her prenatal care has been uncomplicated thus far. On your initial evaluation, the blood pressure is 165/110 mm Hg; the patient is alert and oriented, her abdomen is gravid and tender in the right upper quadrant, there is no fundal tenderness, and there is 2+ pitting edema to the knees bilaterally.
Although we don’t see many pregnant patients over 20 weeks gestation in our ED, it is important to know how to manage this very common obstetrical emergency. Hypertensive disorders are among the most common medical complications of pregnancy, affecting about 7-10% of all pregnant women. (more…)
Author: Robby Allen, MD Answer to last week’s case: reversible cerebral vasoconstriction syndrome (RCVS). Congrats to Drs. Solger and Cerbini for getting the correct diagnosis. Who gets RCVS? RCVS occurs more commonly in women, often in the middle-aged years. The exact incidence is unknown but it may not Read more…
Case A 35-year-old female presents to the emergency department with a chief complaint of headache. She has a past medical history significant for depression, migraines, and seasonal allergies. One week ago, she delivered a healthy newborn by vaginal delivery without any complications and went home the next day. In the Read more…
Written by Dr. Chris Hanuscin Edited by Dr. Wesley Chan Great teamwork by Drs. Jordan Dow, Chris Hanuscin, Paladino, Janairo, and Fan! Case: Notification: “This is FDNY calling in a 41-year-old female, 7 months pregnant with hypotension. BP 70/50, HR 89, ‘Satting’ 99% on RA. ETA 7 min.” We Read more…
You decide to take a break from the city and moonlight in a small rural hospital. You think you’ll be chilling for the night seeing urinary tract infections, or maybe you’ll finally see that snake bite you never thought you’d see. The night starts off slowly with a steady stream 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…
SAVE OF THE MONTH – Thank you Dr. Amy Sanghvi for an unbelievable save of a mother with…. drumroll….. a heterotopic pregnancy!!! Thanks to Dr. Wendy Chan for the nomination. Here’s the scene: A 30 year-old woman G2P1 presented at 8 weeks EGA with worsening abdominal cramps on the right Read more…