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 …
A 64 y.o patient with a history of ALS presents to the ED with shortness of breath. On exam, he is alert but appears to be taking shallow respirations. He has a history of chronic diaphragmatic weakness secondary to his ALS and is on NIPPV at night. His saturation is 94% on room air. You …
Continue reading Critical Care Corner – Respiratory Parameters
A 35 year old male with no PMH presents for SOB. On arrival, the patient is in respiratory distress and is unable to provide any additional history to you. He is 80% on room air with a RR of 29. BP is 180/90, and HR is 125. Temp by axilla is 37.5. A portable CXR …
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 …
A 76 year old woman presents to the ED with progressive leg weakness. The patient states that for several days she’s been having trouble standing from a seated position, and has had multiple falls recently. PMH includes HTN, COPD, neuropathy and chronic hyponatremia (etiology not stated in records). The patient states that for years she has …
An 84 y.o f with no hx of heart or lung disease presents for altered mental status. Per care facility, the patient was in her normal state of health until the day of evaluation when they went to check on her and found her altered. EMS found her hypoxic to 70% and placed her on …
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 …
HPI: 28 YO Caucasian Female with DM type I & h/o right ovarian tumor s/p resection in 2012 presents with 4 days of sore throat. Patient originally visited urgent care 4 days ago, given Keflex and sent home. In the interim, patient has worsening symptoms of sore throat and increasing tender cervical lymphadenopathy R > L. …
A 69 y/o female presents via EMS with altered mental status. The patient is able to tell you her name, but can’t answer any other questions. Her husband states that she has cirrhosis and recently has been having increasing ascites as well as anorexia. She has not been compliant with her lactulose. On exam she …
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)
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