The neck is a particularly tricky area of assessment and management in the trauma patient, as it is the location for many vital structures. Concern for vascular, neurologic, digestive tract, and airway injury are of paramount importance in the evaluation of these patients, as all can be life-threatening. Oftentimes, the neck trauma patient may appear stable, only to have delayed injury found later, causing increased morbidity and mortality. Neck trauma can be split into penetrating injury and blunt injury. [...]

For the patients when you either suspect thrombocytopenia based on exam/history or when the CBC returns with a surprisingly low platelet count...

Ectopic pregnancy is a common and potentially fatal emergency in early pregnancy. Its prevalence is about 2% in the general population, but is as high as 16% in women presenting to the emergency department with concerning symptoms. Ectopic pregnancy is a cause of pregnancy-related death and can also lead to chronic pelvic pain, need for blood transfusions, and long-term infertility. Because of the potentially devastating outcomes, it is imperative that emergency physicians diagnose ectopic pregnancy early and refer patients to the proper specialist care. [...]

As Emergency Physicians, we are always looking for ways to improve the care we provide to our patients. Based on clinical data which have come to light over the past several years, tranexamic acid (TXA) displays considerable promise toward reducing mortality in hemorrhagic trauma. It’s widely available, cost-effective, and an easy way to save lives. Let’s take a look at the evidence and discuss the potential benefit of TXA use in trauma. [...]

It’s 4pm on a Wednesday. As per usual, the chart rack is full, and you’re trying to stay positive and keep up morale of the entire team. You pick up your next chart, and as you read the chief complaint, your heart sinks into your belly. The complaint is, “severe headache,” and you’re already trying to figure out how you’re going to fit an LP into your busy patient load. Headaches are experienced in all types of ways by our patients. Many are benign – but we are in the catastrophe business. How do we know if the headache is actually a brain mass? Or what if it’s a raging intracranial hemorrhage? And if it is a brain bleed, what kind will it be? If we have a suspicion of subarachnoid hemorrhage (SAH), did our mouse click for “head CT (non-contrast)” just commit us and our patient to a lumbar puncture? [...]

Whether we are working with a medical student, an off-service resident, or even one of our own, most of us involved in the education of emergency medicine have described the mindset of emergency medicine as different from most other specialties. But are we really unique in our approach to patient care and how we think? And if so, can one develop this “EM Mindset?” [...]

What if there was a way to better visualize the heart during cardiac arrest? What if you could see something on the ultrasound screen that triggered a specific, critical, and time-sensitive intervention? According to the 2008 ACEP Ultrasound Guidelines, as well as Matt and Mike from the Ultrasound podcast, that emerging emergency ultrasound application is…

Pediatric cardiogenic shock is an often insidious phenomenon with presentations requiring a broad differential diagnosis. Even after narrowing the diagnosis to cardiogenic shock, the list of possible etiologies is vast and the cause important to determine because the source of the shock will respond differently to different treatments.