John Cafaro MD
A 2 year old boy is brought to the Emergency Department after a drowning event. Bystanders noted the child was underwater for 1 minute but was quickly pulled from the bottom of the pool, he coughed and vomited. On arrival, he is aware and alert and behaving appropriately per parents. His GCS is 15. On examination, he has a heart rate of 110, respiratory rate of 30 breaths/minute SaO2 of 98% on room air. His lungs are clear. What is the next step in management?
One of the best risk management strategies is clear discharge instructions.
- Estimated that half of lawsuits in EM are related in someway to discharge planning.
Instructions should be time specific and action specific and include what to return to the ER for.
A 43 year old female is involved in an motor vehicle collision. She complains of facial and dental pain. Exam reveals a broken lateral incisor. A pink spot is noted on the surface of the tooth. What is the diagnosis?
A. Ellis Class I Dental Fracture
B. Ellis Class II Dental Fracture
C. Ellis Class III Dental Fracture
D. Dental Subluxation
Answer: C - Ellis Class III Dental Fracture
A 40 year old male with history of Marfan's Syndrome comes in with sudden onset shortness of breath preceded by tearing chest pain. He is tachycardic to 120, blood pressure is 80/40, patient is tachypneic with increased work of breathing. CXR is consistent with widened mediastinum and pulmonary edema and stat bedside ECHO is concerning for acute aortic regurgitation secondary to aortic insufficiency. Cardiothoracic surgery is consulted. What two medical modalities are contraindicated in this patient?
A. Beta Blocker and Intra-Aortic Balloon Pump