emDOCs Podcast – Episode 99: Multiple Sclerosis in the ED
Davis Sugar, Jess Pelletier, and Brit Long cover multiple sclerosis in the ED.
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FOAMed
EM@3AM: Malignant/Necrotizing Otitis Externa
A 68-year-old male with a history of poorly controlled diabetes presents to the ED with increasing right-sided ear and facial pain, swelling, and difficulty hearing for two weeks. He says the pain is worse at night and when he is chewing. Today, he noticed his right face looked swollen and he had an unequal smile. Triage vital signs include BP 130/75 mm Hg, HR 90 bpm, T 37C, RR 15 breaths per minute, SpO2 98% on room air. A point of care glucose is 148 mg/dL. On exam, the right side of the patient’s face is notably swollen. The right ear is anteriorly displaced by surrounding edema and is erythematous with malodorous discharge. There is facial asymmetry that involves the forehead. Otoscopic exam reveals granulation tissue.
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Journal Feed Weekly Wrap-Up
Clay covers three pediatric articles: the Phoenix Criteria for pediatric sepsis, extremes of weight and risk of intubation, and SBIs in premies.
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emDOCs Revamp: Appendicitis
An 18-year-old female presents to the ED for abdominal pain. The pain began the day prior in the “middle of her stomach,” but is now “lower to the right” and associated with rigors and anorexia. She denies new sexual partners, dysuria, or vaginal discharge, and her last menses was 1 week prior. Triage Vital Signs: BP 109/69, HR 115, T 102.4°F Oral, RR 21, SpO2 99% on room air. She appears uncomfortable but with no acute distress. Her abdomen is soft. She has tenderness to palpation at McBurney’s point, tenderness in the right lower quadrant when palpating the left; evidence of involuntary guarding. What’s the next step in your evaluation and treatment?
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emDOCs Podcast – Episode 98: Post ROSC Mental Model
Zachary Aust and Brit Long cover a mental model for approaching the post ROSC patient.
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EM@3AM: Thoracic and Lumbar Spine Trauma
A 70-year-old female with a past medical history of osteoporosis, atrial fibrillation, and hypertension presents with acute thoraco-lumbar back pain after a ground-level fall. She is stable, but she does have pain at the T-12/L-1 region of her back. She has full motor strength and sensory function in the lower extremities. Her patellar reflexes are 1+ bilaterally, no ankle clonus is noted, and she denies any saddle anesthesia or bowel/bladder incontinence.
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Using Point-of-Care Ultrasound to Identify the Gallbladder
How can you optimize your use of POCUS for the gallbladder?
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Journal Feed Weekly Wrap-Up
Journal Feed covers ketamine versus etomidate, managing high-risk PE, and fludrocortisone plus hydrocortisone for septic shock.
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Medical Malpractice Insights: Speaking in “Code”
Dr. Pilcher looks at discussing resuscitation options with patients nearing end of life
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emDOCs Podcast – Episode 97: Spontaneous Cervical Artery Dissection
The emDOCs cast with Jess Pelletier and Brit Long covers the challenging diagnosis of spontaneous cervical artery dissection.
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