A 62 yo M presents to the ED with 1 week of abdominal distension with associated nausea and vomiting. He has had only 2 small bowel movements in the last week. He denies abdominal pain. On exam, his abdomen is distended and rigid. An obstruction series is obtained and shown below.
Read moreSubmitted by Loran Hatch, DO
Last week we reviewed some causes of dental pain. Here we move into traumatic dental injuries, with an overview of types and management.
Read moreSubmitted by Sandhya Ashokkumar, MD
A 52-year-old man with a history significant for hypertension presented to the emergency department with cough, dyspnea and fever. He progressed to severe acute respiratory distress syndrome (ARDS) secondary to COVID-19 pneumonia. He developed refractory hypoxemia with P/F < 60 mm Hg despite low tidal volume ventilation, paralysis, inhaled epoprostenol and prone positioning. Is this patient a candidate for venovenous ECMO and, if so, who should guide initiation and management of ECMO? The Society of Critical Care Medicine (SCCM) and Extracorporeal Life Support Organization (ELSO) recently published a position paper on the role of the intensivist in the initiation and management of ECMO.
Read moreSubmitted by Emily Damuth, MD
Intra-articular lidocaine as analgesia for shoulder dislocation-reductions
Read moreSubmitted by Sandhya Ashokkumar, MD
65 yo female presents with right ankle pain
Read moreSubmitted by Loran Hatch, DO
It is the middle of the Covid-19 pandemic. A 9 yo male presents with one week of flu-like symptoms. You wonder if this is just a viral syndrome or something more ominous as you head for the room....(it is something more ominous)
Read moreSubmitted by Sydney Tabaac, MD
Dental pain is a common chief complaint in the emergency department, but it can mean many different things. Let's review some of the basics about causes of dental pain.
Submitted by Sandhya Ashokkumar, MD
It’s been a busy day in the ED and you’ve had several cardiac arrests come in back to back. EMS calls in with another one just as they’re hitting the door. The patient is an adult, but you notice the BVM they’re using is much smaller than what you’re used to seeing. The medic says “The day has been so bad, we didn’t have time to get back to base to restock the rig. We only had a pediatric BVM.” Knowing that safe ventilation includes limiting tidal volumes and pressures, you wonder what the implications of using a pediatric BVM are.
Read moreSubmitted by Lars-Kristofer Peterson, MD