respiratory

EM@3AM: Acute COPD Exacerbation

A 58-year-old male presents with severe shortness of breath, productive cough, and decreased ability to ambulate at home. He has COPD and is on oxygen at home. Several days ago he noted worsening congestion, myalgias, and cough. He is now severely short of breath and unable to complete his activities of daily living.
He is hypoxemic and tachypneic. You hear decreased air movement bilaterally and distal wheezes. What’s the next step in your evaluation and treatment?

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Interstitial Lung Diseases: Evaluating for an Acute Exacerbation

Interstitial lung disease refers to parenchymal and interstitial inflammation and fibrosis, and acute exacerbation can cause significant morbidity and mortality. Many conditions are associated with this, including those with an underlying systemic disorder, those with a known trigger, and those that are idiopathic in nature. This post provides key points on evaluation and management of ILD in the emergency department.

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Controversies of Thrombolytics for Pulmonary Embolism

Pulmonary embolism (PE) is a disease process associated with significant morbidity and mortality. The benefits of thrombolytics for massive PE has been established in the literature. But what does the evidence say about the use of thrombolytics for submassive PE? What are the current guidelines and recommendations? As emergency physicians how should we apply the current evidence for the use of thrombolytics in submassive PE?

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