Internal Medicine

"HUGS" as a Novel Treatment for Gastroparesis

It’s the end of a long night shift and you are about to see your next patient triaged as “known history of gastroparesis, presenting with intractable nausea and vomiting.” You know you are in for a rough battle ahead without any good pharmacological choices for treatment.  Enter HALOPERIDOL.

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Intracellular Explosions: TUMOR LYSIS SYNDROME

Oncological patients are at risk of developing several complications including life threatening infections. We often first worry about neutropenic fever in these patients. However, there are other oncological emergencies with which the emergency medicine physician needs to be familiar.

 

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Chvostek’s Sign + Hypocalcemia

Chvostek’s sign is momentary contraction of the nose and/or lips in response to tapping the facial nerve at the angle of the jaw.  Associated with hypocalcemia, it has been found to be poorly sensitive and specific.  It is seen in 10-25% of healthy individuals with normal calcium levels, whereas approximately one third of patients with hypocalcemia will not demonstrate this sign.

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Trials Instead of Tragedy: Unexplained dyspnea on exertion in a healthy young physician....

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!

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Advanced Practice - Paracentesis-induced circulatory dysfunction (PICD)

Do you routinely perform large volume (or near large volume) paracentesis in your ED? If so, you need to know about a potentially life-threatening complication of this procedure...

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Advanced Practice: A Cold Abscess?

A 34 year old Vietnamese male presents with complaint of neck swelling. It began one month ago and worsened over the past few days. He endorses fatigue and a mild weight loss. Exam shows an indurated, non mobile mass without tenderness or erythema.  You order imaging and are concerned for TB but unsure what to do next.

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Baby, It’s Cold Outside: Death by Hypothermia

For some, this topic may be more bread and butter than others. Many of you may work in cold areas where you are likely to see patients with hypothermia on a regular basis, especially in the winter. Whether you work shifts in a mountainous region or are simply catching up on EM topics while studying for boards in your in you flip flops by the beach, here are a few pearls regarding patients who present with hypothermia and their management.

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What to Do With Gonococcal Arthritis in Your Emergency Department

You have made the diagnosis of disseminated gonococcal infection in your patient presenting with history and physical exam findings suggestive of purulent arthritis, now what? Treatment for gonococcal arthritis goes beyond the one-time "shot and a pill" given for uncomplicataed gonococcal infections. A quick review of disseminated gonococcal infection:

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