Emergency medicine clinical tips and articles
Beating the Odds, Twice
A Shocking Adverse Effect Chief Complaint: Defibrillator shock HPI: 50-year-old biologic male who identifies as a female presented after reportedly being shocked by her defibrillator 5 times before calling...
A Shocking Adverse Effect
A Shocking Adverse Effect Chief Complaint: Defibrillator shock HPI: 50-year-old biologic male who identifies as a female presented after reportedly being shocked by her defibrillator 5 times before calling...
The Not So Simple Status Epilepticus From A Tumor That’s Not A Tumor
The Not So Simple Status Epilepticus From A Tumor That’s Not A Tumor Chief Complaint: Seizure HPI: 16-year-old male brought in by EMS for seizure-like activity for 15 minutes...
Tastes so good, hurts so bad
tastes so good, hurts so bad Chief Complaint: Esophageal Foreign Body HPI: 31-year-old male presents to emergency department with reports of an esophageal foreign body. He states that he...
A Superior Cocktail
A SUPERIOR COCKTAIL Chief Complaint: Seizures HPI: 26-year-old male presents to the emergency department by EMS after he reportedly had 2 witnessed seizures by friends, who then called EMS....
The Slow Roller
the slow roller Chief Complaint: Lethargy HPI: 56-year-old male who uses a wheelchair at baseline arrives via EMS from home with complaints of lethargy. EMS was originally contacted because...
Atraumatic Spleen Rupture
Atraumatic Spleen rupture Chief Complaint: Abdominal Pain HPI 41-year-old male presents to the emergency department with reports of the same exact abdominal pain as prior episodes of pancreatitis described...
High Stakes
high stakes Chief Complaint: Chest pain and shortness of breath HPI 37-year-old male reports about 36 hours ago he was on a bicycle riding approximately 20 miles an hour...
A Painful Twist
a painful twist Chief Complaint Abdominal Pain HPI 47-year-old female presenting to the emergency department with approximately 2 hours of right upper quadrant pain described as sharp, constant, worse...
Ludwig’s Angina
Ludwig’s Angina Chief Complaint: Neck and jaw pain HPI: 32-year-old female with a history of IV drug use, last injected methamphetamine 2 days ago, presents for 1 day of...
A Hidden Twist
a hidden twist Chief Complaint Abdominal Pain HPI 5-year-old male presents to the emergency department for abdominal pain, which started this morning. Mother reports the pain woke the patient...
Mr. Freeze
mr. freeze Chief Complaint: Painful wounds on skin for months HPI: 32-year-old male with past medical history of alcohol use disorder and general anxiety disorder presents with painful skin...
STEMI or STEMI mimic? That is the question.
stemi or stemi mimic? that is the question Chief Complaint: Chest Pain HPI 24-year-old male with no past medical history presents to the ER with left-sided chest pain since...
Don’t Pick Your Brain
don’t pick your brain Chief Complaint: Generalized Weakness HPI: 69-year-old male with a self-diagnosis of obsessive-compulsive disorder (OCD) presents to the ED via EMS for being “sick”. The patient...
The Invisible Bleed
the invisible bleed Chief Complaint: Hematemesis HPI: 43-year-old woman with a history of gastroparesis and seizures suddenly vomited blood about 4 hours prior to arrival to the ED. She...
COVID-19 Vaccines
COVId-19 vaccines Introduction COVID-19 has emerged to be the most challenging pandemic faced in the 21st century. With total cases as of April 2021 at about 147 million worldwide...
The Silent Killer Strikes
the silent killer strikes Chief Complaint: Stroke Alert HPI: 68 year old female with past medical history of coronary artery disease status post stent, hypertension, hypothyroidism, hyperlipidemia is brought...
Should have ordered in
should have ordered in Chief Complaint: Hand Burn HPI: 23-year-old right hand dominant male presenting to the emergency department for a burn to the left hand which he sustained...
Pneumatosis Intestinalis
pneumatosis intestinalis Chief Complaint: Generalized Weakness HPI: 55-year-old male with a past medical history of hypertension, diabetes mellitus type II, hypothyroidism and testicular cancer in remission presents to the...
Oh, You Weren’t Just Waving at Me?
Erect sHoulder Chief Complaint: Shoulder Pain HPI: 63 year old female presents after falling while walking down the stairs outside. She notes it was icy on the steps and...
If the Patient Gets Stuck, Know Where to Turn
If the patient gets stuck, know where to turn Chief Complaint: Left hand pain and swelling HPI: 73 year-old right hand dominant female presents about 6 hours after accidentally...
Silent, Scentless and Deadly
Silent, Scentless and Deadly Chief Complaint: Headache HPI: A family consisting of a 22-year-old female, 27- year-old male and 10 month-old male presenting to the emergency department by EMS...
Calcium Burns
Calcium burns Chief Complaint: Calcium Burns HPI: 46 year old male with past medical history of ESRD on HD, hypertension, congestive heart failure and secondary hyperparathyroidism underwent a subtotal...
Lithium Overdose: The Tale of a Light Metal and its Skinny Therapeutic Index
Lithium Overdose: The tale of a light metal and its skinny therapeutic index Chief Complaint: Lithium Overdose HPI: Patient is a 39-year-old male with a past medical history of...
Seeking Pleasure, Suffering Pain
Seeking Pleasure, Suffering Pain Chief Complaint: Abdominal Pain HPI: 21-year-old male presenting to the emergency department after placing a glass mason jar in his rectum 3 days ago, this...
A Rare Package Delivery
A Rare Package Delivery Chief Complaint: Can we get a doctor? HPI: 37-year-old female presents to the ED. Triage nurse announces on the overhead paging system for a doctor...
Coronavirus Testing
Coronavirus Testing Chief Complaint: SOB HPI: 43 year-old male anesthesiologist presents to the ED with increasing shortness of breath, tachycardia and lethargy. Patient reports alternating positive and negative COVID...
A Typical Case of the Pandemic
a typical case of the pandemic Chief Complaint: Altered Mental Status HPI: 69-year-old male with history of diabetes brought in by his son to the emergency department with altered...
TCA Overdose
tca OVERDOSE DISCUSSION: Background: Tricyclic antidepressants (TCA) were introduced in the 1950s to treat depression, but are now more commonly used as migraine prophylaxis and in the treatment of...
Just the Flu?
Just the Flu? Chief Complaint: Seizure HPI: Patient is a 13 month old M presenting to the ED via EMS following a tonic clonic seizure that per EMS, began...
Completely Disassociated
Completely disassociated Chief Complaint: Syncope HPI: An 82-year-old male with a history of bradycardia, HTN and HLD arrives in the emergency department via EMS with altered mental status, pacer...
Superior Vena Cava Syndrome
Superior Vena cava syndrome Chief Complaint: Facial Swelling HPI: Patient presents to the emergency department reporting several days of recurrent facial swelling. She states that when she wakes in...
Gesundheit!!!
Gesundheit!!! Chief Complaint: Headache HPI: 30-year-old female, G1 P0 5 weeks estimated by LMP, states at approximately 08:15 this morning was getting ready to go to work when she...
When MCC Stands for Motorcycle Crash and Most Common Cause
When MCC stands for motorcycle crash and most common cause Chief Complaint: Left Arm Pain HPI: 27 y/o RHD female presented via EMS. Patient was a helmeted passenger on...
Interesting Presentation of DKA
Interesting presentation of dka Chief Complaint: Abdominal Pain HPI: 41-year-old female presenting with reported elevated blood sugars in the 200s, 3 days of vomiting and diarrhea. She states that...
Modified Valsalva Maneuver for SVT
Modified Valsalva Maneuver for SVT Chief Complaint: SVT HPI: Patient is a 49-year-old male with history of prior episodes of SVT and HTN. He stated that over the past...
Back From The Dead
Back from the Dead Chief Complaint: Chest Tightness HPI: 55-year-old male reporting chest tightness 8 out of 10 that began right before getting in the shower just prior to...