52 in 52 – #3: BICAR-ICU
52 in 52 returns with the BICAR-ICU trial! This RCT evaluates the utility of bicarb infusion in critically ill patients with metabolic acidemia.
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renal
EM@3AM: Nephrotic Syndrome
A 25-year-old female with no significant past medical history presents with progressive periorbital and lower extremity edema for one week. She denies recent fever, chest pain, shortness of breath, allergies, or recent travel. Vitals include BP 120/90, HR 90, RR 18, Temp 98.7F. Exam shows a developmentally normal female in no acute distress. She has bilateral pitting edema up to knees without skin changes, but the rest of the exam is normal. Her pregnancy test is negative. What is the likely diagnosis?
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EM@3AM: Peritoneal Dialysis Emergencies
A 42 year-old male presents with abdominal pain and fevers for 72 hours, with nausea and vomiting for 24 hours. He has a history of ESRD and has been on peritoneal dialysis for 5 years. Triage vital signs (VS): BP 105/60, HR 121, T 101.4 temporal, RR 24, SpO2 98% on room air. Pertinent physical examination findings include a tender peritoneal dialysis site and diffuse abdominal tenderness, but no erythema overlying the PD site. What’s the next step in your evaluation and treatment?
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emDOCs Podcast – Episode 26: End Stage Renal Disease Complications
We cover end stage renal disease and complications on today’s podcast.
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Oliguria and Anuria: ED Presentations, Evaluation, and Management
Oliguria and anuria can be associated with a variety of conditions. What do you need to consider in the ED setting?
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Emphysematous Pyelonephritis: ED Presentation, Evaluation, and Management
Why is emphysematous pyelonephritis dangerous, when should you consider it, and what is the management?
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Critical Hyponatremia: Pearls and Pitfalls
Hyponatremia is challenging. This post from Nikita Desai and David Jang looks at the patient with critical hyponatremia.
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The EM Educator Series: The Sick ESRD Patient
The EM Educator series covers ESRD and its complications, dialysis access, and laboratory/medication considerations.
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EM@3AM: Kidney Transplant Complications
A 65-year-old with a history of ESRD and renal transplant presents to the ED with lower abdominal pain and fevers. On exam, his vitals include HR 112, BP 101/62, RR 22, T 101.1, SpO2 98% on RA. His is tachycardic with lower extremity edema and lower abdominal tenderness to palpation. What’s the next step in your evaluation and treatment?
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