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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

    • practice updates

    Concussion Update

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    Concussion is a type of mild traumatic brain injury (TBI) that classically occurs in sports-related incidents but can be due to any traumatic force to the brain. The term concussion stems from the Latin word, concussus, which means “to shake violently." While sport is the most common cause of concussion
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    • practice updates

    The Sick Neonate

    • 2 Comments
    Rapid evaluation and management of the sick neonate is a required skill for the emergency physician. Here we present a brief but comprehensive strategy for resuscitating and stabilizing the critically ill neonate as well as some mnemonics for help remembering the differential diagnosis.
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    • practice updates

    Amiodarone vs Procainamide for Stable VT

    • 5 Comments
    Case Scenario: A 38-year-old male with a history of hypertension and an unknown heart defect status post repair in infancy presents to the Emergency Department with acute onset chest pain, dyspnea, and diaphoresis. He had a similar episode at another hospital 1 month prior that resolved after "some medication." He
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    • From @EMSwami

    Cardiogenic Shock

    • 6 Comments
    Click here to view Tintinalli's chapter on Cardiogenic Shock via Access Emergency Medicine!A 55-year-old man arrives via ambulance in respiratory distress. Paramedics attempted to start an intravenous line but the patient is altered and pulled it out. They were also unable to keep an NRB mask on him. His
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    Spinal Epidural Abscess

    • One Comment
    "Once the classic symptoms appear and a definitive diagnosis is made, the very symptoms we look for have often become irreversible"
    • Spinal epidural abscess is an extremely rare diagnosis but a potentially devastating one.
    • It has proven to be a difficult ER diagnosis.
    • Unfortunately, once the classic symptoms appear
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    • Ask Me Anything

    Ask Me Anything with Steve Carroll, DO (@embasic)

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    Live Blog Ask Me Anything - Steve Carroll, DO
     
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    Trauma Resuscitation

    Primary: CABC vs MARCH (massive hemorrhage, airway, respiration, circulation, hypothermia/head injury)

    Deadly diamond of trauma: hypocalcemia, hypothermia, coagulopathy, acidosis

    If transfusing trauma patient, don’t forget the calcium

     

    If giving TXA, consider using 2g IV bolus; frees IV line, cognitively offloads, supported by TCCC guidelines

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