It is essential for Emergency Physicians to know the standard of care for sexually transmitted infection (STI) treatments, as patients often present to Emergency Departments for evaluation and treatment shortly after exposure to these diseases. The Emergency Department provides patients with rapid screening, diagnosis, treatment regimens, and access to outpatient follow up.
The young female with lower abdominal pain. The middle-aged male with atypical chest pain. The elderly female that presents with vague symptoms of dizziness. These are just the tip of the iceberg of chief complaints we will see in our emergency medicine careers. Those with symptoms that don’t fit into a particular diagnostic box or with totally clean workups can be frustrating for patients and physicians alike. We are taught in medical school that 90% of diagnoses can be made with a very meticulous history and physical. But, until I was asked to write on the topic of diagnostic uncertainty, I had never really thought about how infrequently we actually make a slam dunk, no doubt about it diagnosis.
The Multiple Layers of Diagnostic Uncertainty Read More »
In the midst of flu season with patients flooding your ED with similar presentations, what else do you need to consider? This post examines mimics of the flu, with pearls and pitfalls.
Influenza Mimics: Pearls & Pitfalls Read More »
What do you do with the head trauma patient who is anticoagulated? Do you discharge the patient, observe and repeat CT, or admit the patient? This post evaluates this question and more.
The Anticoagulated Patient with Head Trauma: What’s the Disposition? Read More »
Pearls and pitfalls in managing the trauma patient and finding occult pathology: a little knowledge goes a long way
Occult Trauma: The Eyes Do Not See What the Mind Does Not Know Read More »
The first post in the new EM Primer Series…What are the pearls you need to know for myxedema?
Decompensated hypothyroidism: An EM Primer Read More »
Endophthalmitis is a rare, but clinically significant infection. It is often misdiagnosed due to the multitude of other ocular diseases that share similar presenting symptoms. It results from an infectious or non-infectious inflammatory process of the vitreous and aqueous humors. Missed or late diagnoses can have severe consequences, including permanent vision loss. The natural history of the disease thus necessitates a high degree of clinical suspicion in all patients, especially those at increased risk.
Endophthalmitis Highlights Read More »
Hemolytic uremic syndrome is a potentially deadly disease, comprised of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and acute kidney injury (AKI). This post evaluates the pathophysiology, evaluation, and management of HUS.
Hemolytic Uremic Syndrome (HUS): Pearls and Pitfalls Read More »
In 2002, a new standard of care was established when the Surviving Sepsis Campaign (SSC) highlighted the importance of recognizing sepsis and initiating treatment early. Once we find that a patient meets Systemic Inflammatory Response Syndrome (SIRS) criteria with a source of infection, rapid and appropriate treatment including resuscitation is a must. Early fluid resuscitation is necessary for septic patients, but there is large variance on the aggressiveness of fluid resuscitation. There is disagreement amongst the experts on the total amount of fluids that should be administered and the end points for resuscitation. We must ask ourselves, at what point does our aggressive resuscitation actually start to harm our patients?
Resuscitation in Sepsis: How Much is Too Much? Read More »
Does your choice of fluids for resuscitation in sepsis matter? Multiple studies have been performed to determine whether septic patients benefit from colloid versus crystalloid IV fluids, and other studies have specifically looked at the different kinds of fluids within those specific groups. Debate now exists as to which fluid will improve patient outcomes.
Fluid Choice in Sepsis: Does it matter? Read More »
