A 25 yo female presents with a complaint of abdominal cramping and heavy vaginal bleeding. This is a routine complaint in the Emergency Department and rarely represents a life-threatening emergency....until it does...
Richard Byrne, MD
The Cooper EM Residency recently hosted a spirited debate on the topic of administering thromblytic therapy during cardiac arrest. Drs. Byrne and Roberts faced off in a duel for the ages! Read on to see the results of the largest randomized controlled trial the "TROICA" study and to see the winner (and loser)!
A 63 yo male presents complaining of severe pain to the right shoulder. He has markedly restricted range of motion in the shoulder, without any overlying erythema, edema, or warmth. You take a cursory glance at the xray as you gather supplies to perform an arthrocentesis for suspected septic arthritis...
An 82 yo male presents to the ED complaining of several months of progressive hearing loss in the right ear. For the past 3 days, he can hear a male voice singing opera in the right ear only, 24/7. Read on for a brief discussion of this fascinating phenomenon and how we cured him in 5 minutes!
Check out this lateral film of the wrist. See the fracture? Look again! Surprise...there is no fracture, but this patient has sustained a serious wrist injury with the potential for long term disability. This week we highlight some of the most common missed orthopedic injuries in the ED and suggest a few strategies to minimize the errors.
A 25 yo male with a hx of ESRD due to membranoproliferative glomerulonephritis (MPGN) presents to the ED with complaints of swelling to his LUE, face, and neck progressive over 5 days. He was seen at another ED 2 days prior and had an ultrasound of his LUE fistula as well as a duplex of his LUE which were unremarkable. A CT scan of the chest was ordered, revealing bilateral occluded brachiocephalic veins, which were treated in the interventional radiology suite with balloon venoplasty with resultant resolution of edema.
For decades, Emergency Medicine Providers have struggled to come to a consensus on the management of patients with chest pain with non-ischemic ECGs and negative biomarker testing. Both cardiology and emergency medicine guidelines failed to provide a clear recommendation on which patients should be discharged from the ED. The American College of Emergency Physicians has taken a bold step with their latest guidelines for the management of low risk chest pain patients which will dramatically change standard practice in the care of possible ACS patients.
With the rise in popularity of the NOAC class of anticoagulants, more and more patients with a new diagnosis of pulmonary embolism are being discharged from the emergency department. Multiple risk classifications tools have been developed to help identify patients at low risk of short term mortality. Read on to see if this new study determined which tool is the winner!