What to know when evaluating a child with suspected meningitis
You are in the midst of caring for a 62 year-old male who is tachycardic with HR 120, BP 88/42, T 101.2 oF, RR 26, and SpO2 98%. He was brought in by EMS for fever and myalgias, and with one look at his vital signs, he triggered the protocol for SIRS.
Your initial exam showed similar vital signs, with dry mucous membranes but otherwise normal HEENT exam, clear lungs, normal mental status, nontender abdomen, normal skin and genitourinary exams, and normal extremities/back. Due to his vital signs and SIRS criteria, you were concerned and ordered CBC, RFP, LFT, lactate, blood cultures, urinalysis/culture, and chest xray. You started 1 L NS, and his VS did not improve.
“What Happened?” Recognizing and Preventing Acute Decompensation in the ED Authors: Michael C. Perry, MD (EM Resident Physician/University of Texas at Austin Dell School of Medicine) and Janna Welch, MD (Assistant Residency Director, University of Texas at Austin Dell School of Medicine) // Edited by: Jennifer Robertson, MD and Alex Koyfman, MD (@EMHighAK) The emergency […]
Continuing with our EM Mindset series, here is another great piece by Dr. Michael B. Weinstock to kick off your week. Enjoy!
To kick off your weekend reading pleasure, here’s another batch of our monthly excellent write-ups from the EM interns at UT Southwestern (@DallasEMed) and Icahn School of Medicine at Mount Sinai courtesy of Alex Koyfman (@EMHighAK) and Stephen Alerhand (@SAlerhand) . Our ongoing intern report series is the product of first-year residents exploring clinical questions they have found to be particularly intriguing, with an intended audience of med students & junior residents. Enjoy!
Updates in the ED diagnosis and management of pediatric stroke.
Continuing with our EM Mindset series, here is another great piece by Dr. Amy Kaji to kick off your week. Enjoy!
Case 1: A 55 year-old male with a history of hypertension and hyperlipidemia complains of fatigue, headache, shortness of breath, and blurry vision for the past four days. His exam is normal, but laboratory results show a WBC of 155,000, with differential showing elevated blasts. Chest Xray shows the following: