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A 28-year-old female presents with fatigue, bruising, and vaginal bleeding. She reports a history of heavy menstrual cycles; however, this cycle has been significantly worse. Over the past week, she has experienced dizziness, generalized fatigue, and increased bruising. She felt warm earlier this morning but was not able to take her temperature. She denies any family history of bleeding disorders. Initial vital signs include BP 110/70, HR 120, RR 14, SpO2 100% on RA, and T 100.5F. On exam, she has diffuse petechiae and ecchymoses. Labs reveal hemoglobin 6.5, WBC 1.6, and platelet count of 40. What is the diagnosis?
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A great post by Core EM - Bringing core EM content to anyone, anywhere, anytime. Learn the HIET for beta-blocker and calcium-channel-blocker toxicity by Dr. Jenny Beck-Esmay, MD (@jbeckesmay)
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- clinical cases, FOAMED, In the Literature, practice updates
- Justin Bright
- 5 Comments
Emergency physicians commonly care for poisoned patients. These exposures may be either intentional or unintentional. Salicylates are commonly found in many topical and over the counter preparations, yet salicylate toxicity is often overlooked and underestimated as a potential cause for illness in our patients. Below is a condensed quick-guide of
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- FOAMED, In the Literature, practice updates
- Brit Long
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You've tried your normal asthma treatment pathway, and the patient looks worse... What's next?
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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)
