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EM@3AM: Sarcoidosis and its Complications

A 37-year-old African American female presents with persistent dry cough and generalized fatigue that has been worsening over the last two months. She has had some mild dyspnea on exertion but denies any fevers or unexplained weight loss. She has had a few episodes that she had attributed to the intensity of her cough. On exam, patient has some diffuse intermittent wheezing and a dry cough. There are a few enlarged lymph nodes in the cervical and axillary regions. She additionally has tender, warm, red, and firm subcutaneous nodules on her bilateral pretibial surfaces.

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    Articles

    • practice updates

    Update on LVADs in the ED: Presentations, Evaluation, and Management

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    What's new with LVADs?
    LVAD Image
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    emDOCs Podcast – Episode 141: Acute Limb Ischemia

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    The emDOCs Podcast returns with acute limb ischemia. What should you look for on history and exam, what tests are necessary, and how should you manage acute limb ischemia?
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    • In the Literature

    Journal Feed Weekly Wrap-Up

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    Journal Feed covers CT with contrast and renal injury, prolonged pediatric fever, and steroids in severe CAP in pediatric patients.
    Journal Feed
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    • electrocardiography

    ECG Pointers: MVC with Spinal Injury

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    Dr. Tannenbaum covers a challenging trauma case with spine injury.
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    • em@3am

    EM@3AM: Septic Abortion

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    A 24-year-old female G4P1 who is 9 weeks pregnant presents with abdominal pain and vaginal bleeding for 3 days. Vital signs include HR 115, BP 100/76, T 38.7, RR 13, SpO2 99% on RA. She is ill-appearing and has tenderness to palpation of the bilateral lower quadrants and suprapubic region.
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    • FOAMED, FOAMTOX, practice updates

    Kratom in the ED: Pearls and Pitfalls

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    What do emergency clinicians need to know about kratom?
    Kratom
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    Acute heart failure exacerbation disposition

    Not all patients require admission

     

    Consider patient hemodynamics, respiratory status, ECG, labs (Cr, troponin, sodium/electrolytes), ability to ambulate, follow up

     

    Elevated troponin and serum Cr associated with worse outcomes

     

    Don’t use risk tools alone for DC, but Ottawa Heart Failure Risk Scale may assist in admission (ACEP Level B)

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