26 year old male of filipino descent presents with diffuse motor weakness that was present upon waking this morning at 0400. Patient reports he was of normal health and asymptomatic last night and in the preceding days. Patient denied recent infectious symptoms such as diarrhea, cough, congestion, fevers, chills, urinary changes, rashes or insect bites. …
Continue reading Case of the Month: The paralyzed 26 year old.
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 …
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 …
A 56 y.o m with a hx of HTN and tobacco use presents for chest pain. The patient states that today while mowing his lawn he started getting midsternal chest pain. He has never had this before. It is not pleuritic or positional, and it radiates to his jaw and L arm. EMS arrived and …
An 85 y.o f with a hx of DM and HTN presents with chest pain that awoke her from sleep at 5am. She described the pain as substernal with some mild radiation to the back. It was associated with nausea and lightheadedness. On exam, the patient appeared to be in moderate distress from her pain, …
On a bright sunny morning, a 55 y.o. male uncomfortably staggers into the ED. He is escorted by his cardiac rehab nurse who notifies the ER staff that the patient had a recent cardiac stent placed in the proximal LAD. The patient had chest pain earlier in the day at cardiac rehab that progressively became …
It’s a little after midnight when a middle aged male walks into the ED complaining of chest pain. The triage nurse immediately grabs you because she’s concerned about the way the patient looks. You walk into the room and see a man with mild diaphoresis and stable vitals. He mentions he started having pain in …
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