Joseph Cesarine, MD
Ankle sprains are one of the most common traumatic injuries encountered in the Emergency Department. The pathophysiology of an ankle sprain occurs when there is abnormal movement of the talus within the ankle mortise leading to disruption of the surrounding ligaments.
Practicing in an Emergency Department gives any Emergency Physician a different perspective on many facets of life. We operate on the borders of life and death 24 hours a day, 7 days a week, 365 days a year. However this constant commitment to our patients does not come without a price. For many of us, our careers in Emergency Medicine have some negative effect on our personal wellness and a common area that suffers is our sleep.
Antibiotic use in patients with upper GI bleeding and concomitant liver cirrhosis is standard of care. However, have you ever wondered where that recommendation comes from and what exactly the benefits are?
Planning your next trip to the Rocky Mountains? Treating patients on base camp of Mount Everest? Here are the high-yield basics of High Altitude Illness including Acute Mountain Sickness, High Altitude Cerebral Edema (HACE), and High Altitude Pulmonary Edema (HAPE).
Case: 55 year old female with unknown medical history presents to the Emergency Department by EMS after having a seizure. Prior to the seizure the patient was found "acting strangely" and agitated outside on her street. Patient had a witnessed seizure after police arrived.
Excited delirium syndrome is a pathophysiologic progression that Emergency Medicine physicians are exposed to daily. While the initial management often takes place in the pre-hospital setting, these patients are at high risk of respiratory and cardiac arrest if proper management is not continued after hitting our doors. Despite a growing awareness of excited delirium syndrome and it's associated increased risk of death, the majority of the 250 annual deaths from this entity occur while in police custody.
The diagnosis of Neurocysticercosis was made by the radiologist by the initial CT head without contrast given the pathognomonic findings of the collodial vesicular stage of the disease. An MRI of the brain was obtained the next day. T1, T2, and FLAIR images shown below, respectively: