A 75 year-old male with a past medical history of coronary artery disease, hypertension, and hyperlipidemia presents to the Emergency Department via EMS for concern of altered mental status. His wife is present at the bedside and states that he been becoming progressively more confused over the past 2 days. Prior to this episode, he …
Patient Case A 53-year-old male presents to the ICU as a transfer from outside hospital where he presented for low back pain that started after an injury at work. The patient is a mechanic and reports lifting a heavy vehicle door and hearing a pop in conjunction with acute onset pain in the low back …
History of Presenting Illness A 5-year-old boy was brought to the emergency department with severe abdominal pain, fever, vomiting, rebound tenderness, and guarding. His symptoms strongly indicated acute appendicitis. The pain began just a day ago, initially accompanied by fever and localized to the right lower quadrant. Considering the child's low-grade fever, vomiting, anorexia, and …
Introduction Central venous access is a cornerstone of medical resuscitation in a variety of scenarios. Three primary sites of central cannulation exist, and all three have perceived advantages and disadvantages. Of the three routes, a number of studies have shown benefit to subclavian as opposed to Internal Jugular (IJ) or femoral insertion, although this route …
Continue reading Central Venous Access: Which One is the Best
CASE A 34 year old female, presents to the emergency department with complaints of right shin pain and swelling. Symptoms started 3 weeks ago, persisted, and have not improved. The patient denies preceding trauma. A review of symptoms is otherwise unremarkable. X-ray to evaluate for fractures and ultrasound of lower extremities to evaluate for Deep …
A case review on blast crisis... Case: A patient in his 60s presented to the emergency department with symptoms of abdominal pain, vomiting, and shortness of breath. The patient mentioned he was seen about week ago with gingival bleeding and was diagnosed with gingivitis and sent home with antibiotics. He felt okay up until 3-4 …
19-month-old female presents to the ED for evaluation of shortness of breath and wheezing, seen in walk in clinic just prior to arrival and noted to be 87% on room air. She has been eating and drinking slightly less but has had adequate urine output and has had no noted fevers at home. In arrival …
26 year old male of filipino descent presents with diffuse motor weakness that was present upon waking this morning at 0400. Patient reports he was of normal health and asymptomatic last night and in the preceding days. Patient denied recent infectious symptoms such as diarrhea, cough, congestion, fevers, chills, urinary changes, rashes or insect bites. …
Continue reading Case of the Month: The paralyzed 26 year old.
http://momontheblock.com/ 26-year-old multiparous female approximately 25 weeks gravid presents to the Emergency Room with palpitations. Patient reports that this feels similar to an episode she had during her first pregnancy that resolved after 18 mg of Adenosine. Patient states she was watching television on the couch when symptoms began. Patient reports feeling some mild chest …
Continue reading Case of the Month: Management of Atrial Tachyarrhythmia in Pregnancy
A 56yo female is brought to the ED after being pulled out of a house fire. EMS found patient unresponsive with pulse, in burning house. Patient was extricated from the house and on initial EMS evaluation patient was desaturating on room air. She was placed in nasal canula, but continued to have low oxygen saturation, …
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