You are taking medical command when you receive a call from an ALS unit. They are picking up a 33 y/o male with unknown medical history from the beach for a witnessed seizure and confusion. The patient's friend states they were diving at a nearby shipwreck when they encountered a shark, causing the pair to swim to the surface as quickly as possible. While on the boat, the friend noted the patient was acting strangely with slurred speech.
A 25 y/o male with a history of Type 1 Diabetes presents with acute right shoulder pain.
Check out this great post from Dr. Michelle Lin from ALiEM about ABEM Oral Board Preparation including a video series from the University of Maryland Department of Emergency Medicine!
While most patients presenting to the Emergency Department live in the immediate region surrounding the hospital, modern day travel allows patients to have recent exposures from the far reaches of the globe. One particular zoonotic infection, B Virus, carries a 70% mortality rate if not treated promptly. This post aims to introduce the B Virus and summarize the "need-to-know" as a practicing Emergency Physician:
Staying alert and functioning at a high level during an overnight shift in the Emergency Department is often a matter of life or death for your patients. Many of us employ the use of caffeine at all hours to combat the slow (sometimes rapid) creep of fatigue which hampers our skillset. Most providers can relate to those moments when a cup of coffee is just not what you are looking for. This post intends to introduce an alternative vehicle for caffeine designed for members of the military: Military Energy Gum.
The most commonly used induction agent for rapid sequence intubation in the acutely injured patient is etomidate, largely due to its rapid onset of action and hemodynamically "neutral" effects. The dose-dependent effect of etomidate in suppressing adrenal synthesis of cortisol leading to adrenal insufficiency has left the door open for ketamine to be also considered as the rapid induction agent of choice in these critically injured patients.
Ketorolac (toradol) remains one of the giant pillars of pain management in the Emergency Department as the climate of non-opiate analgesia strengthens. This post aims to summarize recently published evidence revealing a lower analgesic ceiling for this medication.