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 …
Erythema Nodosum
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 …
My Blood Gone Wild
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 …
The PLUS Trial and the Great Crystalloid Debate
IV fluids provide the basis of resuscitation in an acute care setting. Many patients will only require relatively low volumes while in the emergency department, but there are also a number of common pathologies that require a large volume resuscitation. While the proper volume of fluid for these common pathologies has been well established, whether …
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Atypical allergies: Urushiol Oil
Case report: A 23-year-old female presents to the emergency department due to the development of a perioral rash that has developed over the past few days that is intensely pleuritic, she reports the rash looks like “little bubbles” and when she looked up pictures online “it looks like herpes”. She reports she has not been …
Dizziness or a HINTS of Something More
Case A mid 60s female patient was brought into the emergency department via ambulance after a motor vehicle accident that occurred 20 minutes prior in which she was the restrained driver. She has known past medical history of hypertension, hyperlipidemia, and obesity. The accident occurred on a residential street where the patient reportedly was driving …
Tetralogy of Fallot; A Case Report
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 …
Levothyroxine; a clinical discussion
Levothyroxine (also known as synthroid) is a synthetic T4 analog commonly used in the treatment of primary, secondary, and tertiary hypothyroidism, and a medication that is often encountered in the Emergency Department. As an NTI (narrow therapeutic index) medication, levothyroxine can have clinically serious side effects if sub- or supratherapeutic doses are taken by the …
Sympathetic Crashing Acute Pulmonary Edema (SCAPE)
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 …
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POCUS Peritonsillar Abscess: A literature Review
Title: Evidence-Based Medicine Improves the Emergent Management of Peritonsillar Abscesses Using Point-of-Care Ultrasound. J Emerg Med. 2020 Nov;59(5):693-698. doi: 10.1016/j.jemermed.2020.06.030. Epub 2020 Aug 19. What is already known about this topic?Ultrasound is an accepted modality for detecting peritonsillar abscess (PTA). There are two described approaches transcutaneous with linear transducer and intraoral with an endocavitary probe …
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