As the number of COVID-19 cases rises drastically and the global pandemic continues to change life as we know it, we are all hoping for news of effective treatment. Approximately 15 percent of patients infected with SARS-CoV-2 develop pneumonia requiring supplemental oxygen and an additional 5 percent progress to critical illness and acute hypoxemic respiratory failure. Although numerous drugs have been investigated, only dexamethasone has demonstrated improved survival in patients hospitalized with COVID-19 in a randomized controlled trial design. We now have data from 3 randomized controlled trials to guide the use of remdesivir for severe COVID-19.
Submitted by Emily Murphy, MD
Back pain. A chief complaint generally not considered among the top 5 most thrilling for EM docs. Hiding among a sea of benign musculoskeletal conditions, however, lurk a handful of diagnoses which will result in irreversible paralysis and severe loss of function for our patients. The trick, of course, is figuring out who needs expensive advanced imaging and who can go home with NSAIDS....read on for a case that definitely falls into the former category....Read more
Submitted by Sandhya Ashokkumar, MD
A young female presents in your ED waiting area in active labor. What steps are you going to take to safely delivery the baby and prevent fetal and maternal complications?Read more
You receive a prehospital stroke alert from ALS for a 73 yo male found down, minimally responsive. "Pretty routine" you think as you listen to report from the paramedic...that is, until you hear the vital signs: "Blood pressure is 270 over 140." That's the highest blood pressure you've ever heard of and you immediately begin to worry about how the human brain can possibly tolerate this as you head to the resuscitation bay to assemble your team...Read more
Submitted by Alyse Volino, MD