46 year-old female with diabetes presents for sore throat and facial swelling for the past 3 – 4 days. Patient states she’s been experiencing difficulty with chewing due to pain. The patient also endorses tactile fevers. On exam, you notice multiple dental caries and submandibular swelling. Read more…
You scan the board for your next patient in fast track when you see the chief complaint: hand laceration. Great! You grab your suture set and lidocaine (without epinephrine of course) and prepare for another quick “treat and street” and head to see the patient. Wrong. You realize there is a deep laceration to the palm side of the fingers and this may not be as simple as you once thought.
Cellulitis is commonly diagnosed and treated in the Emergency Department ED) with considerable variation in treatment and disposition patterns. These patients may be: Given a dose of intravenous (IV) antibiotics before discharge home Placed in observation unit for IV antibiotics before transitioning to oral medications prior to discharge Discharged with 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…
Last month we discussed the use of needle aspiration as an alternative to placing a traditional large-bore chest tube in patients with spontaneous pneumothoraces. One of the selling points of using these less invasive methods is that they decrease the amount of time these patients spend in the hospital. In fact, Read more…
ED Management of Hypercalcemia of Malignancy Hypercalcemia in the ED is often times an incidental finding. The clinical presentation, management and treatment of hypercalcemia as it specifically relates to malignancy will be discussed here. Workup of hypercalcemia When considering the diagnosis of hypercalcemia, it is important to understand calcium’s distribution Read more…
A young woman’s life was truly saved by the one and only… Dr. Molly Cutright! A 28 year-old woman with no past medical history was brought in by EMS for altered mental status. EMS reported that the patient had “belly pain and was pregnant.” She was moaning and not making Read more…
Let us set the scene: You have a patient complaining of shortness of breath. The patient gives a poor history, but your spidey sense tells you this is obstructive pulmonary disease vs. new-onset heart failure. His corpulent body habitus is limiting your ability to reliably hear heart or lung sounds. Read more…
A young, tall, athletic man is brought to your emergency department by ambulance after he experiences sudden-onset shortness of breath. He’s tachypneic but not has otherwise normal vital signs upon examination. You’re not sure if you hear breath sounds on one side. Being the ultrasound enthusiast that you are, you Read more…
It is another long Saturday night in the emergency department and you are entrenched in the general chaos of discordant sounds, noxious smells, and inconceivable sights. You are notified by the nurse of a disheveled regular of your ED who has a history of alcohol abuse and pancreatitis and today Read more…