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EM@3AM: Septic Abortion

A 24-year-old female G4P1 who is 9 weeks pregnant presents with abdominal pain and vaginal bleeding for 3 days. Vital signs include HR 115, BP 100/76, T 38.7, RR 13, SpO2 99% on RA. She is ill-appearing and has tenderness to palpation of the bilateral lower quadrants and suprapubic region. Pelvic exam reveals blood in the vaginal vault and foul-smelling discharge from the cervix with no other abnormalities. What is the likely diagnosis?

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    Articles

    emDOCs Podcast – Episode 127: Intubation EBM Updates Part 1

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    Today we start a series on EBM updates for intubation. In Part 1 we cover predicting difficult BVM/intubation/cricothryotomy, physiologic factors associated with peri-intubation decompensation, preoxygenation, and apneic oxygenation.
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    • In the Literature

    Journal Feed Weekly Wrap-Up

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    Journal Feed brings you nerve blocks and peds nurse US.
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    • EM MINDSET

    EM Thinker: Pearls from the Frontlines

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    The EM Thinker returns with 10 pearls.
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    • perspectives

    Managing Conflict: Best Practices

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    How can you manage conflict in the ED?
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    EM@3AM: Pediatric Non-Accidental Trauma

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    A 3-month-old previously healthy male is brought to the ED by his parents. His father says he rolled off the couch onto a hardwood floor, started crying immediately, and then seemed sleepy and more fussy than usual. On exam, the patient is minimally consolable with a small bruise on his
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    US Probe: Upper Extremity DVT

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    How can you use POCUS to diagnose upper extremity DVT?
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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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