EM@3AM: Hypertensive Emergency
A 63-year-old female presents with nausea, vomiting, and altered mental status. Initial VS demonstrate BP 225/121, HR 88, 98% RA, T 98F, RR 18. What are your next steps?
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EM@3AM – Hyperthermia
A 23-year-old male is brought in by EMS with agitation. His VS include T 41 C, HR 133, BP 182/115, RR 26, D stick 118. EMS is concerned for ingestion, and the patient is not cooperative. What’s your next step?
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EM@3AM: Post Cardiac Arrest Care
A 42-year-old male is brought in by EMS with ventricular fibrillation. You are finally able to obtain ROSC, though the patient remains comatose. What are your next steps? This week’s EM@3AM covers post cardiac arrest care.
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EM@3AM: Uterine Perforation
Welcome to EM@3AM! This week’s post evaluates a case of a 31 y/o female who presents with severe, acute lower abdominal pain 6 hours after a D&C for an elective abortion. What do you need to know?
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EM@3AM – Hypothermia
A 42-year-old female presents with altered mental status after being found outside. She is bradycardic and hypotensive, and your normal thermometer reads “Error”. You ask for a core monitor, which provides a reading of 27C.
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EM@3AM – Rhabdomyolysis
This week’s EM@3AM brings you a case of a patient with myalgias and dark urine after exercising.
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EM@3AM – Hyperemesis Gravidarum
A 32-year-old G2P1 at 7 weeks presents with weight loss, nausea, and vomiting, sent by her primary care physician. She has ketones present, and she has lost 8 lbs. Read this week’s EM@3AM for more on hyperemesis gravidarum.
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EM@3AM – Hemolytic Uremic Syndrome
A 2-year-old female presents to the ED with 3 days of fever, cough, congestion, and watery diarrhea. The patient’s mother is concerned as the toddler had two episodes of bloody diarrhea prior to arrival. You obtain a stool sample: fecal occult blood test is positive. Read this week’s review to find out why HUS should be on your differential diagnosis.
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EM@3AM – Electrical Injuries
A 34-year-old male presents to the emergency department following a “shock” to the hand. Per the patient, while installing a ceiling fan thirty minutes prior to arrival, he experienced the sudden onset of severe pain in his right hand when it made contact with an exposed wire. He is currently asymptomatic. Is an evaluation warranted? Let’s take a look at this week’s review of electrical injuries.
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EM@3AM – Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
A 32-year-old female, with a history of rheumatoid arthritis (methotrexate therapy), presents to the emergency department for severe itching, mouth ulcers, and a diffuse rash. The patient denies recent travel, sick contacts, and new exposures. Review of systems is positive for abscess/cellulitis treatment (cephalexin and trimethoprim/sulfamethoxazole) three weeks prior to arrival. What diagnosis should be on your differential? Take a minute to read this week’s review of DRESS.
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