The Complicated Delivery: What do you do?

Deliveries that occur in the emergency department are high-risk and high-stress situations. ED OB patients often have little or no prenatal care, and ED births have a higher perinatal mortality. The emergency provider needs to expect the unexpected, including precipitous delivery, shoulder dystocia, malpresentation, umbilical cord emergencies, hemorrhage, and multiple gestations. In this post, we explore what to do in these dangerous situations.

Mediastinitis: ED-focused basics

The mediastinum is the space between the pleural sacs which extends from the diaphragm superiorly to the superior aperture of the thorax. Mediastinitis is an infection involving the structures of the mediastinum, and this disease is a surgical emergency with potentially devastating consequences and serious threat to vital structures. This post provides the information that you need to know concerning this deadly disease.

Managing a Massive Hemothorax: A Guide to Stabilizing Your Patient

A hemothorax most commonly occurs secondary to penetrating or blunt chest wall trauma, with up to 70-80% of hemothoraces due to motor vehicle collisions. These injuries can cause rapid decompensation, but diagnosis and management isn’t always easy. This post is filled with pearls and pitfalls in diagnosis and management of massive hemothorax.

A Case of Severe Brown Recluse Envenomation

The brown recluse spider, Loxosceles reclusa, is a spider known for the potential to cause serious wounds. The spider is found in North America primarily, often hiding in man-made structures. The poison contains a myriad of toxins including metalloproteinases, hyaluronidases, insecticidal peptides, deoxyribonucleases, and alkaline phosphatase. Most bites heal without issue; however, this post details the course of a bite causing significant morbidity.

Intraabdominal Catastrophes in the Pregnant Patient

Though many obstetric complications occur during pregnancy, the pregnant woman is still a woman with all her other organs that can be at risk, regardless of her pregnancy status. Typically, patients with obstetric complications will complain of uterine tenderness, vaginal bleeding and may have abnormal fetal heart tones on monitoring. When signs and symptoms do not support an obstetric cause for the patient’s abdominal pain, it is imperative that the differential is still wide for all other causes.

Emergency Medicine Education