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EM@3AM: Aplastic Anemia

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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    Platelets and ddAVP in the Management of Intracranial Hemorrhage

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    Evidence-based guidelines and information for the management of intracranial hemorrhage in patients taking anti-platelet agents
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    Outpatient PE treatment

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    Editor's note: This post was listed in the LITFL Review 153's "Best of #FOAMed" category. Venous thromboembolism (VTE) (deep vein thrombosis or pulmonary embolism) has an incidence of roughly 1 in 1,000 with an incidence of PE with or without DVT of 2.3 per 10,000. One major factor to
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    Ultrasound for Pediatric Skull Fractures

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    Diagnose important traumatic injuries quickly, avoid unnecessary ionizing radiation in kids, and do so with an extremely easy ultrasound application to learn. Moreover, skull fracture found to be more predictive than scalp swelling or vomiting for traumatic brain injury, increasing likelihood by 4-fold to 20-fold.
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    Intern Report Collection

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    Our ongoing intern report series is the product of first-year EM residents at UT Southwestern exploring clinical questions they have found to be particularly intriguing. For med students & junior residents - if you haven't encountered these issues yet, you will!
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    Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Pediatric Population

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    Etiologies, Clinical Course, Diagnosis, Management...and ED PEARLS
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    Ask Me Anything with Scott Weingart, MD (@emcrit)

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    Live Blog Ask Me Anything with Scott Weingart
     
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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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