Fri, 09/04/2020 - 3:00am

It's a typical day in the ED.  You are asked to see your next patient who is a 60 year old male, recently discharged from the hospital after being treated for cellulitis presenting with abdominal pain and diarrhea.  He’s tachycardic and hypotensive to 75/40.  The patient is mentating well.  After taking a more thorough history your differential diagnosis narrows in on intra-abdominal sepsis associated with significant volume losses.  The lactate returns at 6.  On volume assessment by physical exam and POCUS, the patient is significantly volume down.  You know that getting the antibiotics and fluids on board is the cornerstone of treatment, but they will take some time to be given.  You wonder if you should temporize your resuscitation with pressors during the time it takes for the fluids and antibiotics to be administered.

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Thu, 09/03/2020 - 7:00am

Dr. Volino discusses Serotonin Syndrome

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Wed, 09/02/2020 - 3:00pm

A 44 yo M presents to the ED w/ L foot and ankle pain. He was running and stepped into a hole, stating he heard a "crack". He has been unable to bear weight since the injury. On exam, he has swelling and marked bony tenderness of both the lateral and medial malleoli and heel.

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Tue, 09/01/2020 - 5:11am

You are called to the trauma bay to evaluate an 18 yo male involved in an MVC. Your nurse tells you that he seems ok but keeps repeating himself. You wonder what injuries you should be concerned for and what your diagnostic approach should be as you enter the patient's room.....

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Mon, 08/31/2020 - 5:00am

A few quick basics and pearls about ectopic pregnancy in the ED

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Sat, 08/29/2020 - 9:15pm

 

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Fri, 08/28/2020 - 3:00am

A 60-year-old man presents to the ED after an episode of syncope. He is initially hemodynamically stable and undergoes CT demonstrating saddle pulmonary embolism. He returns from radiology with tachycardia and hypotension refractory to fluids and requiring vasopressor support. Bedside echo reveals RV dilation and severely reduced RV systolic dysfunction with septal flattening consistent with RV pressure overload. As you start systemic anticoagulation with heparin, you consider the indications for thrombolysis, surgical embolectomy and VA-ECMO.   

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Thu, 08/27/2020 - 6:00am

Do you know which substances in YOUR house are capable of causing debilitating tissue injury if ingested?

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Wed, 08/26/2020 - 12:10am

 

 

A 40 yo female presents with knee pain

 

 

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Button batteries
Tue, 08/25/2020 - 3:40pm

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