A 50-year-old female comes to the ED with a headache. The room is dark as I enter and she is holding her head with her hands. She reports that the pain started suddenly while driving and was instantly the worst headache she ever had. The pain hasn't changed at all. There was no trauma. She …
Often times when presenting a patient as an intern, we’ll feel that our attending is being a tad overzealous. Is it possible this man with back pain has an aortic dissection? Yes, it is. Is it out of the realm of possibilities? Just about. However here is a case that plays homage to the classic …
EMS calls to let you know that they have a 7 year old male with an acute asthma exacerbation. They report that the child has increased work of breathing and is currently receiving a duoneb treatment. Five minutes later they arrive. The child appears uncomfortable, grey and tired on arrival. He has a respiratory rate …
Continue reading Pediatric Pearls – Case of the Month (September)
A 10 y.o f presented to the ED with a rash. The patient had a recent history of several days of tactile fevers as well as URI like symptoms per the mother that resolved, but then a rash began to develop. The rash was initially on the patient’s back but then began to spread diffusely …
A 75 y.o m not on blood thinners presents for epistaxis. He states that for the last 2 hours, he has had bleeding from his bilateral anterior nares. He attempted to hold pressure at home without resolution. He feels a slight trickle of blood down his posterior pharynx, but denies any difficulty breathing or speaking. …
The post below was reviewed and edited by the guest lecturers Dr. Wiegand and Dr. Nacca from the University of Rochester toxicology department. Flumazenil is a nonspecific competitive antagonist of the benzodiazepine receptor, which can be used to reverse benzodiazepine-induced sedation following general anesthesia, procedural sedation, or overdose. However, the use of flumazenil in the …
With spring in the area, the temperature is warming up and maybe that bambi remake announcement was the final push needed to get people out on the trails and hiking through the hills again. With the increased traffic through the woods comes the inevitable presence of those freeloaders that hop on for a lift and …
Continue reading Bread and Butter EM: Tick for tat, Which Tick is that?
Bronchiolitis is a diagnosis frequently made in the setting of the emergency department and a major cause of illness in infants and children less then 2 years of age. It is most commonly a result of viral infection, typically respiratory syncytial virus (RSV) and is more common in winter months. It is characterized by upper airway …
A 51 year old male presents for altered mental status. On arrival to the emergency department he was agitated, diaphoretic, and was having hallucinations requiring sedation with benzodiazepines for patient and staff safety. Post sedation he was noted to have worsening diaphoresis and tachycardia and was having intermittent myoclonic jerking movements. Family was with the …
When patients come to the ED and are diagnosed with pneumonia, it can be confusing to figure out which antibiotics to administer. Previous thinking separated community acquired pneumonia (CAP), hospital acquired pneumonia (HAP), and health-care associated pneumonia (HCAP). However, health-care associated pneumonia has been dropped from the newest treatment guidelines published in 2016 because studies …
AOMC FOAMed 
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