What should you consider when evaluating a patient for DVT in the rural setting?

A 50-year-old female with no past medical history presents to the ED with a diffuse, constant headache onset a few weeks. The patient describes droopiness of the left eye and double vision associated with specific directional movements of the eye. On exam, you note ptosis of the left eye with findings as indicated in the photograph below (inability to adduct, ability to abduct). The left pupil is dilated at 5mm and minimally reactive to light; the right pupil is 3mm and reactive. The remaining cranial nerve testing and components of the neurological exam are normal.

Welcome to the emDOCs Videocast. These videos will cover post summaries, take homes on clinical condition, and EBM/guideline literature updates. Our first video provides EBM updates on steroids in severe community-acquired pneumonia and CT in post ROSC OHCA.

emDOCs Revamp looks at DRESS.

Journal Feed covers IN fentanyl for pediatric sickle cell crisis, replacing the nail after nail bed repair, and IV fluid volumes in sepsis.

Today on the emDOCs cast with Jess Pelletier and Brit Long, we discuss a case of hypokalemic periodic paralysis.

The American College of Gastroenterology recently released updated guidelines for managing patients with lower GI bleeding (LGIB).  This post will provide the major takeaways for emergency clinicians.

A 32-year-old female with a history of hypertension and autoimmune hepatitis status post liver transplant 6 weeks prior on tacrolimus and mycophenolate presents to the ED with abdominal discomfort. For the past two days, she describes worsening pain and intermittent vomiting. She came today because her sister is a nurse who noticed her eyes were yellow. She denies fever or a new rash. She has been taking her medications as prescribed. Vital signs: HR 118, BP 103/68, RR 20, T 99.8. On exam the patient is tachycardic with RUQ pain to palpation and scleral icterus. LFTs are in the thousands.