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 …
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: 45 y/o healthy male with no significant pmhx who presents to the ER with complaints of RLE pain/swelling over the past 2 days. States he was recently on a road trip to Montana with the family and after returning home, noticed the symptoms. Denies any SOB, chest pain, fevers, chills, dizziness, or changes in …
Introduction: As medicine is ever changing, new diseases and symptomatology are being classified differently according to the etiology, presentation, clinical findings, and treatments of subsets of disease pathology. There have been various names throughout the continued advancement of medicine for acute pulmonary edema, but there have also been various clinical findings and differences in treatments …
Continue reading Sympathetic Crashing Acute Pulmonary Edema (SCAPE)
Intro: Distal digital trauma is common and often associated with cosmetic and functional disturbances.Underlying lacerations are often masked by gross deformities of the nail and hematomas.Crush and blunt force injuries are usually the mechanisms involved with nail deformities and underlying nailbed injuries.Treatment can often necessitate nail removal based on clinical judgement and suspicion of underlying …
As ED doctors, we’re often handed EKGs every few minutes. Our minds initially will always go to ST elevations and possible myocardial infarctions. With this in mind however, what are the other, lesser seen variants that are equally as dangerous and also warrant immediate catheterization? Hyper-acute T waves Before starting to discuss STEMI equivalents, let’s …
31 year old female presents to the emergency department at 34 weeks pregnant with complaints of a headache. Upon examination the patient also notes she’s having blurred vision and is found to have a blood pressure of 150/90. The first differential on every emergency physician’s mind should be pre-eclampsia, but with this in mind, what …
Continue reading Everything you need to know about Pre-Eclampsia
Introduction of Case 47-year-old male presents for evaluation of right sided chest pain that started one week ago. He states that within the last five days, his pain has gotten progressively worse. He reports dyspnea, sharp pleuritic chest pain, worse with inspiration. Vitals at triage note HR 96, O2 Sat 100% on RA, RR 14. …
44 year old male presents to ED with a medical history of hypertension and notes several vague complaints including numbness, fatigue, and slurred speech. Patient’s girlfriend notes that over the last several days the patient has been acting strangely, slurring his speech, appears confused, while periodically falling asleep. Physical exam is grossly negative with the …
Continue reading Toxic Alcohols and the 5 minutes before the exam
A 34 year old male with a medical history of hypertension, hyperlipidemia and chronic liver injury secondary to alcohol abuse presented to the emergency department with diffuse abdominal pain and more than 30 episodes of vomiting over the past 12 hours. The patient admitted to increased alcohol intake over the past two days, however stated …
AOMC FOAMed 
You must be logged in to post a comment.