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
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. …
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, …
Antacid monotherapy is more effective in relieving epigastric pain than in combination with lidocaine. A randomized double-blind clinical trial. What is already known about this topic?i. There have been studies in the past which failed to show conclusive evidence that the addition of lidocaine to a “cocktail” was more effective at relieving symptoms associated with …
Continue reading Lidocaine’s (lack of) role in Epigastric Pain
42 year old female presents to Emergency Department with a chief complaint of vision changes. Patient states that has has been having vision changes in her right eye starting two weeks prior. She denies injury to the eye and recent infections and does not use contact lenses. Patient also states it first started out as …
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
Troubleshooting the Ventilator Terms to know: Tidal Volume (TV)= amount of air that moves in or out of the lungs with each respiratory cyclePlateau Pressures (PPlat)= reflect pulmonary compliance as well as the pressure applied to small airways and alveoli. It can be measured by applying a brief inspiratory pause after ventilation. Peak Pressures (PIP)= This …
46 year old male presents to the Emergency Room after eating a peanut, face swollen with inspiratory stridor. EMS reports being unable to intubate with the patient currently having a saturation of 78% on 100% CPAP. You take a look with your laryngoscope and see edema with no sign of vocal cords. The patient becomes …
Photo by Pixabay on Pexels.com It is important to develop a consistent method to read ECG's as an EM physician. This method should be thorough, but able to be completed rapidly. Without a structure, it is much more likely to miss a critical finding on the ECG. I have tried multiple different methods, each with …
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