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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

    POCUS Diagnosis of NSTI

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    How can you use POCUS to evaluate for necrotizing soft tissue infection?
    Feature POCUS NSTI
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    • In the Literature, practice updates

    2026 Guideline: Evaluation and Management of Acute PE

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    The AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN published a de novo guideline providing recommendations for evaluation, management, and follow-up of adults patients with PE. This post summarizes these new guidelines.
    Featured PE
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    • em@3am

    EM@3AM: Morel-Lavallée Lesion

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    A 30-year-old female presents after sustaining a motorcycle collision at highway speeds. She was wearing protective equipment, including a helmet, gloves, knee and elbow pads, and riding boots. She denies loss of consciousness but reports severe right lower extremity pain rated as 10 out of 10. Vital signs reveal BP
    em@3am logo
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    emDOCs Podcast – Episode 135: Ectopic Pregnancy Myths Part 1

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    This podcast evaluates myths and misconceptions in ectopic pregnancy, focusing on risk factors, history, and exam.
    emDocs Square Podcast Logo
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    • In the Literature

    Journal Feed Weekly Wrap-Up

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    Journal Feed brings you NIPPV for severe asthma, CT for diagnosis of globe rupture, and non-IV ketamine for pediatric sedation.
    Journal Feed
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    • electrocardiography

    ECG Pointers: Another Crashing Patient at Sign Out? Well Flec me…

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    ECG Pointers covers flecainide toxicity and the ECG findings.
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    Multiple sclerosis

    Immune-mediated, demyelinating disease, separated in time and space, females > males

     

    Presents with exacerbations, med complications, or some other condition (most common)

     

    New neuro symptom = true exacerbation -> steroids

     

    Worsening of prior neuro symptoms = pseudoexacerbation -> find and treat underlying trigger (infection)

     

    Avoid fever; worsens symptoms

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