A 23 yo male with a hx of insulin dependent diabetes and recurrent admissions for DKA presents to the ED with complaints of diffuse body aches. He is acutely ill appearing, agitated, and combative with staff, demanding pain medication, entering other patients rooms, and screaming. Realizing that this patient is severely ill, you wonder how you will de-escalate or sedate this patient safely to enable life-saving care to be rendered.....
Read moreSubmitted by Richard Byrne, MD
Basics of how to diagnose and manage alveolar osteitis, or 'dry socket', a common cause of dental pain following tooth extraction
Read moreSubmitted by Loran Hatch, DO
Patient-ventilator asynchrony is underrecognized yet associated with increased mortality, ICU length of stay and duration of mechanical ventilation in critical illness. How do you diagnose and treat it? Hint: the answer is rarely deep sedation or paralysis!
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Submitted by Emily Damuth, MD
Patient presents to the ED with non-specific complaints of intermittent fever, nausea, vomiting, abdominal pain, cough, congestion, headache and myalgias over the past 1 week. Returned from Pakistan 1 month ago.
DDx: Malaria vs Dengue vs Chikungunya vs Influenza vs HIV ...
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Submitted by Loran Hatch, DO
A 30 yo M presents to the ED complaining of atraumatic lower back pain x 2 days
Read moreSubmitted by Loran Hatch, DO
A 56 yo male with a hx of TBI, subglottic stenosis, tracheomalacia, and tracheal stenosis presents in acute respiratory distress. There is a strange looking trach in place with no balloon for a cuff. You begin to wonder how you will manage this pt if he ultimately requires mechanical ventilation.....
Read moreSubmitted by Richard Byrne, MD
What do excedrin, pepto bismol, aspirin and oil of wintergreen have in common? Salicylates! As we know, this common drug can be quite toxic in overdose. Here we review the basics of salicylate poisoning.
Read moreSubmitted by Stacy Marshall, MD
A 17-year-old female presents to your ED with abdominal pain. Her vital signs are as follows: BP 90/60, HR 120, RR 16, and SpO2 99%. LMP is unknown. A urine pregnancy test is pending.
Read moreSubmitted by Kat Kaminski, MD
A 72-year-old man develops generalized tonic-clonic activity at home. He receives lorazepam 4 mg intravenously during the 7-minute transport to the ED. He continues to have witnessed convulsions on your examination. Point-of-care glucose is normal. After supporting his airway, breathing and circulation, what medication should be administered second line for status epilepticus (SE)?
Read moreSubmitted by Emily Damuth, MD