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em@3am

EM@3AM: Malaria

A 42-year-old male presents with headache, fever, chills, nausea, and myalgias. He returned from a month-long trip to Africa several weeks ago. On examination, he is tachycardic and febrile. You do not find a rash or meningismus, but you palpate an enlarged spleen and liver.  What is your next step in evaluation and management?

R.E.B.E.L. EM

R.E.B.E.L. EM – Coronary Computed Tomography Angiography (CCTA): The Holy Grail of “Low Risk” Chest Pain Evaluation?

CCTA has become a popular modality in the ED setting to assess anatomic atherosclerotic disease in patients presenting with chest pain. Advocates of CCTA feel that CCTA has a greater accuracy in identifying obstructive coronary artery disease and identification of high-risk disease compared to standard physiologic testing. However, many published trials on CCTA were not adequately powered to evaluate patient oriented end points.