practice updates

Abnormal vital signs are poor predictors of mortality associated with pulmonary embolism (PE). Diagnosis of PE and right ventricular (RV) strain with transthoracic echocardiography (TTE) however, has been well documented as a predictor for pending shock and significant in-hospital mortality.

“Rash” seems to be a ubiquitous complaint some days in the Ped ED. Knowing that the skin is the largest organ, it seems only appropriate that we should take these complaints seriously. Unfortunately, often I feel a little inadequate when trying to decipher the code of the Pediatric Rash.

Pearls and pitfalls for EKG Analysis in the Emergency Department

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.

Missed occult fractures and dislocations, in general, may result in significant morbidity for the patient and law suites for you. Six cases are presented in this episode, ranging from common scaphoid fractures to rarer dislocations. Dr. Sayal & Dr. Mamen answer questions such as: Which fractures can mimic ankle sprains and how do you avoid missing them? What are the most reliable signs of scaphoid fracture? In which occult orthopaedic injuries should we anticipate limb threatening ischemia? Which is better to diagnose occult fractures – MRI or CT? Which calcaneus fractures require surgery and which ones can be managed conservatively? and many more……

Pearls and pitfalls in managing the trauma patient and finding occult pathology: a little knowledge goes a long way

The first post in the new EM Primer Series…What are the pearls you need to know for myxedema?

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.

Sepsis is a common, serious medical condition diagnosed and managed in the ED. What do EM providers miss, and how can we improve?

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.