A 59 year old male presents complaining of unsteadiness on his feet and vomiting for 24 hours. You know there are numerous benign explanations for his symptoms, but also realize there are a few "can't miss" diagnoses as well...what are they and how do we assess for them in the ED?
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.....
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.....
You are evaluating a patient for abdominal pain the usual way (with a CT of course!) when you discover an incidental pericardial effusion. Quick as a flash you grab your trusty ultrasound and head back to the patient's room, wondering how this effusion got there and what POCUS findings you should be looking for...
A 56 year old male presents to the ED with confusion and abdominal pain. You notice a fistula in his upper extremity. A tech hands you his triage ECG and you scrutinize it for the tell-tale signs of a common, life-threatening diagnosis in hemodialysis patients, while wondering what the initial steps in management are....
A 41 yo male is brought in by EMS after self inflicted stab wounds to the neck and chest. As the patient is transferred to the ED stretcher, you frantically try to recall the initial priorities in the management of this potentially deadly injury....
A 37 year old male is brought to the ED for acute onset of confusion and agitation. He is combative and only intermittently following commands. Read on to discover the ultimate obvious, and yet cryptic, diagnosis!
You are evaluating a patient with the sudden onset of palpitations. You note a regular, narrow complex tachycardia at a rate of 160 bpm and suspect a reentrant tachycardia. You think "adenosine" but secretly wonder if there is a better option, or what you'll do if this fails....
Independently interpreting plain film imaging is an essential skill for the Emergency Medicine provider. Among the most notorious of injuries likely to be missed is the Maisonneuve fracture. In this post we demonstrate the "can't miss" imaging findings to ensure that you don't make the mistake of thinking this is "just an ankle sprain!"
As with most complaints in Emergency Medicine, headaches are usually benign and self-limited conditions. Occasionally, however, the etiology can be potentially devastating, particularly in post-partum patients...
