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EM@3AM: Meningococcal Disease

A 12-year-old girl presents to the ED with a 2-day history of headache and fever. The patient started vomiting with fevers this morning, and her mother was unable to wake her from her afternoon nap. She is lethargic and responds to painful stimuli with temperature of 38.2 C, blood pressure 88/65 mmHg, and HR 132 bpm. She has a petechial rash on her lower back and lower extremities, as well as resistance to neck flexion. What is the diagnosis?

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    EM@3AM: Meningococcal Disease

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    A 12-year-old girl presents to the ED with a 2-day history of headache and fever. The patient started vomiting with fevers this morning, and her mother was unable to wake her from her afternoon nap. She is lethargic and responds to painful stimuli with temperature of 38.2 C, blood pressure
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    Update on LVADs in the ED: Presentations, Evaluation, and Management

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    What's new with LVADs?
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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.
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    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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    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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