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EM@3AM: Scleroderma and Severe Sequelae

A 45-year old African American woman presents with progressive fatigue over the past week and has experienced intermittent episodes of severe hand pain that typically self-resolve. She has also noted a worsening headache over the last day. Her blood pressure is 197/105 mm Hg and heart rate is 90 bpm. The physical exam is notable for smooth and taut skin on the patient’s face and hands. Laboratory values show a creatinine of 3.1 mg/dL. What is the likely diagnosis?

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    EM@3AM: Scleroderma and Severe Sequelae

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    A 45-year old African American woman presents with progressive fatigue over the past week and has experienced intermittent episodes of severe hand pain that typically self-resolve. She has also noted a worsening headache over the last day. Her blood pressure is 197/105 mm Hg and heart rate is 90 bpm.
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    • FOAMED

    Shift Pearls: Multiple Sclerosis

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    Shifts pearls returns with multiple sclerosis.
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    • perspectives, practice updates

    Rural EM: PREOXI Trial Protocol In Rural Life

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    How do you apply the PREOXI trial to rural emergency medicine?
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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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    Anticoagulation with heparin in PE

    If patient needs heparin, consider using LMWH instead of UFH

     

    LMWH more effective in PE, less bleeding, uses subcutaneous route

     

    UFH may be preferred for cardiac arrest or persistent shock, ESRD, invasive procedure or surgery required, or active major bleeding

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