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practice updates

Sinusitis Mimics: ED-relevant pearls and pitfalls

Your next patient is a 17-year-old male you had seen one week before for fever and congestion, diagnosed with a viral upper respiratory infection.  He returns this time for nasal congestion, severe frontal headache, fevers, sore throat, and nasal drainage.  When he looks around the room, he gets dizzy and is seeing double.   He is febrile, tachycardic, and ill appearing, and you note proptosis of the right eye, a sluggish pupil, and inability to move the eye due to pain. Is this sinusitis, or something more sinister?

practice updates

ECG Pointers: Pericarditis

Welcome to the new ECG Pointers, an EMDocs series designed to give you high yield tips about ECGs to keep your interpretation skills sharp. Today, we look at pericarditis.

em@3am

EM@3AM: Endocarditis

A 26-year-old female presents with fevers and chills. She is febrile and tachycardic, with normal BP. You think you hear a murmur on exam, and on further questioning, she says she regularly uses IV drugs. What should you consider, and what are your next steps?

em@3am

EM@3AM: Hypertensive Emergency

A 63-year-old female presents with nausea, vomiting, and altered mental status. Initial VS demonstrate BP 225/121, HR 88, 98% RA, T 98F, RR 18. What are your next steps?