-Case- A 27-year-old previously healthy male presents with pleuritic chest pain, low-grade fever, and shortness of breath for 2 days. His EKG shows nonspecific ST changes and his troponin is slightly elevated. He denies recent travel or known sick contacts but does recall having a viral illness about a week ago. He looks anxious, his […]
Spotting Myocarditis in the ED: Viral Fallout Read More »
-Case- A 67-year-old man with a history of HTN and daily aspirin use presents with a persistent nosebleed for the last hour. He’s tried applying pressure and using tons of tissues but nothing has helped. He’s hemodynamically stable, but actively bleeding from the right naris. -Evaluation- Epistaxis is fairly common in the ED and thankfully,
Epistaxis in the ED: When it Bleeds, it pours Read More »
-Case- A 54-year-old woman comes to the ED after nearly falling out of bed that morning. She reports a sudden, intense spinning sensation when she rolled over, lasting less than a minute. She feels better sitting upright but gets dizzy again when she turns her head to the right. No hearing loss, tinnitus, headache, or
BPPV in the ED: off balance Read More »
-Case- A 64-year-old man presents to the ED after collapsing while walking his dog. He reports brief lightheadedness before passing out and waking up on the sidewalk a minute or two later. He denies seizure-like activity, incontinence, or confusion afterward. His vitals are normal and ECG shows sinus rhythm; labs are unremarkable. He insists he
Syncope in the ED: Drop It Like It’s Hot Read More »
-Case-A 22-year-old tall, thin male walks into the ED complaining of sudden-onset sharp left-sided chest pain and shortness of breath that began while playing video games. He denies trauma, fever, or cough. On exam, he’s tachypneic, with decreased breath sounds on the left and hyperresonance to percussion. to the same side. Oxygen saturation is 95%
Pneumothorax in the ED: Blown Away Read More »
-Case- A 27-year-old woman shows up to the ED complaining of red, itchy eyes for the past 3 days. She reports watery discharge and that the symptoms started in one eye and spread to the other. No vision changes or pain are noted, and she mentions a few of her coworkers have had something similar
Conjunctivitis in the ED: Red Eye Rundown Read More »
-Case- An 18-month-old boy is brought into the ED by frantic parents who found him next to an open bottle of industrial-strength cleaner under the kitchen sink. The child is drooling excessively, refusing to eat or drink, and crying inconsolably; he’s stable but clearly uncomfortable. You check vitals: HR 140, RR 32, Sat 99% on
Caustic Ingestions in the ED: Hide the Bleach Read More »
-Case- A 34-year-old man is brought in by EMS after being found unresponsive on a sidewalk. He has pinpoint pupils, shallow breathing at 6 breaths per minute, and a HR of 58. A bystander reportedly gave him “something that helps with overdoses,” and he briefly woke up before becoming somnolent again. You slap on oxygen
The ED Approach to Opioid Overdose: Respirations Low, Stakes High Read More »
-Case- An elderly woman walks into the ED complaining of a new, persistent headache localized to her right temple. It’s been going on for days and she describes it as “pounding.” She’s also noticed some blurry vision in her right eye and says chewing seems to fatigue her jaw more than usual. Her vitals are
‘Giant Cell’ Arteritis in the ED: Temporal Tantrum Read More »
-Case-It’s 2 AM, and the respiratory therapist flags you down. A 28-year-old man with a history of asthma is gasping for air in Room 3. He’s using accessory muscles, can barely speak, and is clearly struggling. He’s satting at 89% on room air, and you can hear audible wheezing on auscultation of his lungs. -Evaluation-Asthma
Managing Asthma Exacerbations in the ED: All That Wheezes Read More »
-Case-A 25-year-old man with type 1 diabetes presents with abdominal pain, vomiting, and confusion. His breath smells fruity, and he’s breathing rapidly. You grab a point-of-care glucose: 450 mg/dL. Labs confirm metabolic acidosis with an anion gap and a potassium of 5.2. -Evaluation-DKA occurs when insulin deficiency leads to unchecked lipolysis and ketone production, causing
Diabetic Ketoacidosis In the ED: Too Sweet to Handle Read More »
-Case-A 62-year-old male with a history of uncontrolled HTN presents with sudden-onset, tearing chest pain radiating to his back. He’s diaphoretic, tachycardic, and his right arm systolic BP is 40 points lower than the left. CXR shows a widened mediastinum. -Evaluation-Aortic dissection is a life-threatening condition where a tear in the intimal layer of the
Aortic Dissection in the ED: On a Tear… Literally Read More »
