recent articles


EM@3AM: Basilar Artery Occlusion

A 68-year-old male with a past medical history of hypertension, diabetes mellitus, and CAD with a drug eluting stent placed 2 months ago presents with dizziness and vomiting that began 3 hours ago. He has been having “issues with [his] eyes” today and “not feeling quite right.”  Vital signs include BP 165/83, HR 81, RR 18, SpO2 96%. On exam, you notice he has dysarthric speech, limb ataxia, and vertical gaze palsy, which he reports is new. You perform a NIHSS which scores a 3 for mild dysarthria and ataxia in two limbs.


EM@3AM: Crush Injury

A 17-year-old girl, in moderate distress, is brought in by EMS after a motor vehicle collision. EMS reports that she was “pinned” underneath the dashboard, and it took several hours to extricate her. Triage vital signs significant for BP 103/69, HR 99, SpO2 99% on 2 L NC, RR 25, Temp 98.6. She has normal mental status but is in distress with severe pain in her legs. On exam she has erythema, ecchymosis, and gross deformities to bilateral lower extremities but intact distal sensation and palpable pulses. She refuses to move her legs secondary to pain. Laboratory testing reveals elevated potassium and CK. What is the diagnosis?