A 31 yo male presents after assault. Walking into the room, you immediately notice marked edema around his left eye. He also seems restless and agitated and is pulling away from staff attempting to obtain vital signs and obtain IV access. Read on for pearls regarding this patient's vision threatening injury!
Richard Byrne, MD
Think just because you are a young, healthy physician that you are invinceable? Read this post and remember that we are vulnerable too...even more so because we often refuse to acknowledge when we are sick. This week's Advanced Practice topic comes to us courtesy of a Cooper EM alum. The story is told with full permission from the patient, his wife, though names are omitted to prevent any possible HIPPA entanglements!
A patient is brought in by EMS in severe respiratory distress, though o2 sats are normal and lungs are clear on auscultation. You wonder what is triggering the patient's severe tachypnea as you contemplate intubation....
A 37 year old male is brought to the ED for acute onset of confusion and agitation. He is combative and only intermittently following commands. Read on to discover the ultimately obvious, and yet cryptic, diagnosis!
A 76 yo female with a history of Stage IV breast Ca with metastasis to the lung presents to the ED with acute shortness of breath 10 hours after an outpatient placement of a right sided PleurX chest tube for drainage of recurrent malignant effusion......
Independently interpreting plain film imaging is an essential skill for the Emergency Medicine provider. Among the most notorious of injuries likely to be missed is the Maisonneuve fracture. In this post we demonstrate the "can't miss" imaging findings to ensure that you don't make the mistake of thinking this is "just an ankle sprain!"
A 32 yo male suffering from dental pain for the past several days presents to the ED complaining of abdominal pain. He notes ingesting large quantities of acetaminophen for the pain. Your triage nurse notes he is hypoxic on RA at 86%, but oddly this does not rise when the patient is placed on oxygen....
A healthy 32 yo unvaccinated male presents with shortness of breath. "Easy, it's Covid" you think as you head for the room. But what about this other complaint? Abdominal pain? What's that about?
A 63 year old male arrives via EMS in acute respiratory distress. Medics note he is in atrial fibrillation with a heart rate in the 150s. You ponder the age old question as you walk to the resuscitation bay: "Is the high heart rate causing the respiratory distress or vice versa?"
Most patients presenting to the ED with a headache have a simple primary headache: tension, migraine, or cluster. Detecting the "other" etiolgies for headache, which can result in neurologic devastation or death, is often a diagnostic challenge. He we give some quick hits for one of the "can't miss" headaches, how it presents, and how to diagnose it.