A 30-year-old male presents after a motor vehicle accident with chest pain and shortness of breath. He is alert, speaking in 1-2 word responses, and appears in moderate respiratory distress. He has normal left sided breath sounds, but none on the right. No lung sliding is seen with ultrasound examination of the right thorax. His trachea is deviated left, and increased JVD is noted. What is this patient’s presentation consistent with? What is your next step in management?

Let us take a moment to review one of the “zebras” in children - Acute Cerebellar Ataxia

This EM Educator evaluates urinary retention, the ED evaluation, and management.

Last month’s case was an example of a missed MI due to anchoring bias based on the patient’s prior history of pulmonary fibrosis. In this month’s brief summary, we are reminded that myocarditis is another cause of chest pain that must be considered, especially in younger patients.

A pediatric trauma patient needing a definitive airway is a frightening situation. This post from Joe Ravera covers this and more.

This week Clay brings you three great articles on lactate, ultrasound for central line confirmation, and empiric MRSA coverage in pneumonia.

While community acquired pneumonia (CAP) is ‘bread and butter’ emergency medicine, and the diagnosis is often a ‘slam dunk’, it turns out that up one third of the time, we are wrong about the diagnosis; that x-rays are not perfect; that blood work is seldom helpful; that not all antibiotics are created equal and that deciding who can go home and who needs to go to the ICU isn’t always so clear cut.

This week's EM Educator brings you the can't-miss ankle and foot diagnoses.