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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

    Thromboelastography (TEG®) for Trauma

    • 2 Comments
    Editor's note: This article was listed in LITFL Review 154's "Best of #FOAMcc Critical Care" section.

    Using thromboelastography in goal-oriented algorithms, clinicians may be able to optimize targeted transfusion therapies with specific coagulation factor(s) instead of empirically administering multiple components with potentially hazardous effects.

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    Bounceback: An Unrelenting Headache

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    CC: Headache First visit HPI: 29 year old female with a prior history of headaches, presented with two days of gradual onset, atraumatic, right sided headache that is throbbing in nature. The patient reported heaviness about the eye but no visual changes or disturbances. No neck pain, fevers, chills. She
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    • practice updates

    Don't be RASH: Emergency Physician's Approach to the Undifferentiated Lesion

    • 4 Comments
    Editor's note: This post was listed in both the #FOAMED Review from EM Curious AND in the LITFL Review 154 "Best of #FOAMed" section.

    As an EM physician, it is difficult to have working knowledge of the hundreds of different types of rashes that exist. However,

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    Left Bundle Branch Block in Myocardial Infarction: An Update

    • 7 Comments
    Editor's note: This article was listed in the LITFL Review 154's "Best of #FOAMed" section.

    The left bundle branch arises from the Bundle of His, and subsequently is divided into the anterior and posterior fascicles. The anterior fascicle is usually supplied by septal perforators from the Left Anterior

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    • practice updates

    Ventilator Management in COPD

    • 4 Comments
    Editor's note: This post was listed in the #FOAMED Review (17th Ed.) from EM Curious. It ALSO appeared in LITFL Review 154's "Best of #FOAMcc Critical Care" section.

    Its 7:01am. Your shift in your department’s high acuity area is just beginning, and you are waiting to

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    • practice updates

    Platelets and ddAVP in the Management of Intracranial Hemorrhage

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    Evidence-based guidelines and information for the management of intracranial hemorrhage in patients taking anti-platelet agents
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    High lateral OMI

    Elevation in I, aVL, +/- V2 with depression in inferior leads, especially III (South African Flag sign); occlusion of first diagonal branch or left circumflex artery
     
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