Shift Pearls: Acute Heart Failure Exacerbation Disposition
Shift Pearls returns with disposition of the ED patient with heart failure exacerbation.
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#FOAMcc
EM@3AM: Thoracic Outlet Syndrome
A 35-year-old female presents with intermittent right arm pain and numbness that has been worsening for the last month. Symptoms are worsened by lifting her arm above her head. She has also noticed new hand swelling and a “cold” sensation in her fingertips. On exam, she has diminished sensation in the 4th and 5th digit with noticeable hand swelling. What is the diagnosis?
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ECG Pointers: The Journey of aVR
ECG pointers focuses on lead aVR this week. From The Forgotten Lead to the Harbinger of Left Main Disease to …
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EM@3AM: Sarcoidosis and its Complications
A 37-year-old African American female presents with persistent dry cough and generalized fatigue that has been worsening over the last two months. She has had some mild dyspnea on exertion but denies any fevers or unexplained weight loss. She has had a few episodes that she had attributed to the intensity of her cough. On exam, patient has some diffuse intermittent wheezing and a dry cough. There are a few enlarged lymph nodes in the cervical and axillary regions. She additionally has tender, warm, red, and firm subcutaneous nodules on her bilateral pretibial surfaces.
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Journal Feed Weekly Wrap-Up
Journal Feed covers pediatric intranasal midazolam dosing, 0/1 vs. 0/3 hour troponin pathways, and a provider in triage model.
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ECG Pointers: Long Intervals and Squiggly Lines
Dr. Tannenbaum returns with a case of prolonged QT and a dangerous arrhythmia.
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Premedication to Prevent Contrast Reactions: Myths and Pearls in the ED
What’s the evidence behind premedication for contrast reactions? This post from Kevin Molyneux and Jenny Beck-Esmay breaks down the myths.
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EM@3AM: Retrobulbar Hematoma
A 35-year-old male presents with left eye pain and vision loss after an unwitnessed altercation. On exam, there is significant left periorbital edema and ecchymosis; the left eye appears mildly proptotic. He is unable to open the eye unassisted due to swelling and pain. His left eye has conjunctival injection, chemosis, and a dilated pupil, which is non-reactive to direct light but constricts in response to light shone in the contralateral eye. The patient is unable to participate in extraocular testing secondary to pain and distress. Intraocular pressures are 18 on the right, 42 on the left.
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Journal Feed Wrap-Up
Journal Feed covers prehospital whole blood, crying infants, and sodium bicarbonate for in-hospital cardiac arrest.
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Shift Pearls: Anticoagulation with Heparin in PE
Shift pearls returns with anticoagulation for PE.
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