Thursday

#EMconf: 24 y.o. with Near Syncope

For the final week of our cardiology module, Dr. Lisa Filippone presented a great case.  A 24 y.o. male  playing basketball developed palpitations, lightheadedness, dizziness and almost 'passed out'.  On arrival to the ED the patient looked well and had no complaints except for palpitations:  HR 190, BP 130/70.  Lungs were clear, heart without an audible murmur and neuro exam was unremarkable.  ECG shown is shown.  What is the diagnosis and treatment?   

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#EMconf: Acute SOB

This week at our EM/Cardiology interdisciplinary conference, Dr. Lisa Filippone presented a case of a 75 year old male who presented with acute SOB.  This patient presented to the ED 3 days after a NSTEMI with hypotension and hypoxia.  No injury pattern was identified on his ecg but his CXR was consistent with pulmonary edema.  A bedside ECHO was performed that revealed the diagnosis....

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#EMconf: Serotonin Syndrome

To wrap up our toxicology module, Dr. Sumaya Mekkaoui reviewed serotonin syndrome.  This can be a challenging diagnosis to make and is often misinterpreted as other psychiatric or medical syndrome.  Look ahead for a quick review on the  clinical presentation, drugs implicated in serotonin syndrome, and comparing/contrasting similar toxidromes.  

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#EMconf: The (Dis)Utility of the Urine Drug Screen

The Urine Drug Screen (UDS) is a commonly used test in the emergency department, however there are many shortcomings that limit its diagnostic utility. The Urine Drug Screen is exactly that – a SCREENing and not a confirmatory test!  This week Dr. Lauren Murphy educated us on: 1) the potential false positives and negatives of the UDAS and 2) the detection times that drug metabolites are at a concentration in the urine to trigger a positive result (cutoff value).  Read ahead for the reference tables!    

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#EMconf: Ultrasound vs. CXR for Pediatric Pneumonia

Have you considered using ultrasound to diagnose pneumonia in children?   This week for his critically appraised topic, Dr. Michael Coletta researched whether point-of-care ultrasound is a better imaging study for diagnosing pediatric pneumonia than chest xray.  Read ahead for the details....  

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