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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 126: Upper GI Bleeding Evidence and Controversies Part 2

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    We're back with Part 2 on upper GI bleeding. Today we cover endoscopy, other interventions for bleeding cessation, intubation, and risk scores.
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    • In the Literature

    Journal Feed Weekly Wrap-Up

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    Journal Feed covers antibiotics for cirrhotics with upper GI bleed, ondansetron for discharged pediatric patients, and the STANDING algorithm for vertigo.
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    EM@3AM: Tachycardia

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    A 70-year-old male with presents with 5 days of fever and 3 days of anuria and malaise. He also notes worsening abdominal distention and shortness of breath. He found and removed a tick 3 weeks ago and another one 1 week ago. Labs reveal WBC 2,200 cells/microL, HGB 11.2 g/dL,
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    • FOAMED, FOAMTOX, perspectives, practice updates

    Alcohol Use Disorder in the ED: Screening and MAUD

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    A 70-year-old male with presents with 5 days of fever and 3 days of anuria and malaise. He also notes worsening abdominal distention and shortness of breath. He found and removed a tick 3 weeks ago and another one 1 week ago. Labs reveal WBC 2,200 cells/microL, HGB 11.2 g/dL,
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    EM@3AM: Panhypopituitarism

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    A 70-year-old male with presents with 5 days of fever and 3 days of anuria and malaise. He also notes worsening abdominal distention and shortness of breath. He found and removed a tick 3 weeks ago and another one 1 week ago. Labs reveal WBC 2,200 cells/microL, HGB 11.2 g/dL,
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    • Podcast

    emDOCs Podcast – Episode 125: Upper GI Bleeding Evidence and Controversies Part 1

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    Today we have Part 1 on upper GI bleeding, including background, NG tube lavage, blood product transfusion, proton pump inhibitors, prokinetic agents, somatostatin analogues, and antibiotics.
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    SVT Treatment Options

    If unstable -> cardioversion; may attempt modified Valsalva while prepping for cardioversion

     

    Stable -> modified Valsalva while prepping meds: adenosine, CCB, or BB

     

    CCB has similar efficacy and fewer side effects compared to adenosine

     

    If using adenosine, go with 12 mg; tell patient about expected symptoms (and that means it’s working!)

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