Emergency Medicine Cases

OCTOBER 11, 2022

Rest of patient: is there a complication of pacemaker insertion related to the pocket (hematoma, infection), lead (pneumothorax, DVT), or heart (pericardial perforation), or is there an emergency unrelated to the pacemaker (eg dehydration, sepsis, GI bleed).

EKG/ECG 52

EKG/ECG Dehydration Sepsis EMS 52

EMergucate

JULY 13, 2015

A 61 year old female with evidence for sepsis, anaemia and dehydration 1. Microcytic hypochromic anaemia Fe deficiency with elevated … Continue reading →

Dehydration 40

Dehydration Sepsis EMS 40

EMergucate

SEPTEMBER 2, 2015

Abnormalities: Primary Respiratory alkalosis – Lactic acidosis – sepsis, dehydration … Continue reading → A 17 year old male presents potentially seriously unwell 1.

Dehydration 40

Dehydration Sepsis EMS 40

RebelEM

FEBRUARY 2, 2023

This could have biased the results in favor of amiodarone as we’ve covered this before on REBEL EM before The IV amiodarone group required less additional HR control agents to control increased heart rate. Sepsis, hyperthyroidism, dehydration, heart failure, ACS, etc).

Emergency Department 52

Emergency Department Administration EMS Dehydration 52

Dr. Smith's ECG Blog

JUNE 20, 2020

He was not interested in remaining hospitalized for further cardiac monitoring or inpatient EP consultation as he felt well, was convinced dehydration was the reason for his syncope, and he adamantly wanted to go home. There is a limit to the amount of voltage that prehospital ECGs in most EMS systems are able to display.

EKG/ECG 52

EKG/ECG Dehydration Hospitals Wellness 52

Dr. Smith's ECG Blog

AUGUST 9, 2018

They gave him water with salt, as he thought he was dehydrated." Figure-1: Initial ECG on the 58yo man in this case at the time EMS arrived ( TOP tracing ). He writes: "We were dispatched to a 58 yo male who had been out in the sun for 2-3 hours as a mailman. He stated he almost passed out, and bystanders called 911.

EKG/ECG 52

EKG/ECG Dehydration EMS Hospitals 52

Dr. Smith's ECG Blog

MARCH 15, 2023

Emergency providers only see the “tip of the iceberg” of this huge number of AFib episodes — which consists of patients who call EMS or present to the ED with new-onset palpitations, heart failure exacerbation, acute stroke ( or other symptom related to their AFib ).

EKG/ECG 52

EKG/ECG Dehydration Stroke Shock 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. En route, EMS administered aspirin 325mg by mouth, but withheld nitroglycerin due to initial hypotension. Answer below in the still shot.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

EB Medicine

JULY 8, 2019

Jeff: And while it’s not exactly core EM, we’re going to briefly discuss indications for bariatric surgery, as this is something we don’t often review even in academic training programs. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in. At 6 to 8 mL/kg.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EMergucate

JUNE 17, 2014

Elderly male from nursing home presents critically unwell with severe hypernatraemia following a seizure. Seizure and altered mental … Continue reading →

Seizures 40

Seizures Dehydration EMS 40

EMergucate

JUNE 24, 2014

A 3 month old girl is brought to your Emergency department after 3 days of diarrhoea and vomiting. She is unwell, lethargic, has sunken eyes, a sunken fontanelle and dry mucous membranes. Describe …

Emergency Department 40

Emergency Department Dehydration EMS 40

EMergucate

JUNE 24, 2014

This is a 3 month old (weight 5kg) critically unwell child who requires resuscitation with concomitant assessment to determine the … Continue reading →

Resuscitation 40

Resuscitation Dehydration EMS 40

EMergucate

NOVEMBER 2, 2016

A 70 year old man presents feeling unwell. His blood tests show:Severe hypernatraemia with renal failure Osmolality = 332.9+Glucose Glucose ie … Continue reading →

Dehydration 40

Dehydration EMS 40

EMergucate

FEBRUARY 21, 2017

75 year old NH resident presents following a fall at the nursing home. He has severe hypernatraemiaNa 178 metabolic alkalosis … Continue reading →

Dehydration 40

Dehydration EMS 40

EMergucate

MAY 10, 2017

A 26 year old man presents with a febrile illness and vomiting. He is unwell, with low BP and tachycardiaTriple … Continue reading →

Dehydration 40

Dehydration EMS 40

EMergucate

MAY 17, 2017

An 80 year old man sent in by Surgeon looking unwell post bowel resection for bowel obstruction. Abnormal vital signs … Continue reading →

Dehydration 40

Dehydration EMS 40

EMergucate

JANUARY 23, 2018

A 70 year old lady post abdominal surgery presents SOB. She has mild hypotension and tachypnoea Blood results:Moderate acidosis which … Continue reading →

Dehydration 40

Dehydration EMS 40

EMergucate

NOVEMBER 13, 2018

A 24 year old with fever, vomiting and abdominal pain who is unwell with possible abdominal sepsis. Her blood results … Continue reading →

Sepsis 40

Sepsis Dehydration EMS 40

Pediatric EM Morsels

SEPTEMBER 20, 2024

Considering HUS and treating dehydration early has been shown to help keep the dialysis machine away! The post Hemolytic Uremic Syndrome (HUS): Rebaked Morsel appeared first on Pediatric EM Morsels. Sure this may cause blood in stool, but consider Hemolytic Uremic Syndrome when evaluating pediatric patients with Bloody Diarrhea.

Pediatrics 164

Pediatrics Ultrasounds Dehydration Emergency Department 164

EMDocs

DECEMBER 16, 2023

We’ll keep it short, while you keep that EM brain sharp. A 34-year-old male is brought via EMS after collapsing during an outdoor adventure race. EMS reports the patient was conscious but altered, with slurred speech and confusion. The post EM@3AM: Hyperthermia appeared first on emDOCs.net - Emergency Medicine Education.

Hyperthermia / Hypothermia 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

EMDocs

MAY 9, 2024

He has been ill for 3 days with abdominal pain, fever, diarrhea, and vomiting, and his father thinks his son is dehydrated. He reasoned that dehydration and orthostatic hypotension led to a syncopal episode with limb shaking. The elevated WBC could be due to dehydration. EM is a “team sport.”

Seizures 105

Seizures Dehydration Documentation/Coding Infectious Diseases 105

Pediatric EM Morsels

JULY 28, 2023

Kids < 5 years of age New onset of diabetes at presentation Longer duration of symptoms Severity of acidosis Elevated BUN Greater degree of dehydration and hyperventilation Cerebral Edema and DKA: Diagnostic Considerations Early detection and treatment is the best means to prevent brain injury and death. Pediatr Diabetes.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

EMDocs

DECEMBER 6, 2024

6 Can see subsequent electrolyte disturbances and dehydration related to severity of GI symptoms. Typically presents in the first few hours following ingestion. Children without vomiting within 6 hours of iron ingestion will almost never have significant toxic effects. In severe toxicity, hematemesis, melena, or hematochezia may occur.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

ACEP Now

OCTOBER 30, 2023

Oftentimes, it can be an indication of pain, infection, distress, anxiety, dehydration, or the first sign of sepsis. EM Resident. The inverse is also true; what’s normal for most may be significantly abnormal for that patient and be the first red flag. One commonly used example is tachycardia. Open Access Emerg Med. 2022; 14: 441–456.

Sexual Assault 98

Sexual Assault Teamwork Dehydration Outcomes 98

EB Medicine

DECEMBER 4, 2019

Most of the dehydration that occurs is more likely due to inadequate water intake and excess caffeine and alcohol consumption depending on the time of day. Physicians reportedly respond 44% of the time, followed by nurses at 20% and EMS providers at about 4%. Nachi: Interesting. Nachi: Don’t judge.

Dehydration 40

Dehydration EMS Wellness Burns 40

Dr. Smith's ECG Blog

JULY 24, 2018

He had been given 3 grams Ca gluconate by EMS. The most common to consider include renal failure, dehydration, acidosis, use of potassium-retaining medication, and trauma ( which may result in rhabdomyolysis ). The right foot was mottled and pulse was not palpable but was sensed on doppler. Ortho and nephrology were consulted.

EKG/ECG 52

EKG/ECG Dehydration Resuscitation Documentation/Coding 52

PEMBlog

MARCH 27, 2024

It is not the job or the expectation of the EM provider. GI symptoms are the second most common, and they include vomiting, food intolerance, food aversion, GERD, refractory to normal antireflux measures, diarrhea, and dehydration. Now the important thing for EM providers to know is that this can mimic the presentation of sepsis.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

Taming the SRU

MARCH 31, 2023

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed.

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. Jeff: The hyperemetic phase lasts 24-48 hours and can lead to dehydration, electrolyte abnormalities, and weight loss. This is often associated with an inability to tolerate po.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

OCTOBER 7, 2023

We’ll keep it short, while you keep that EM brain sharp. 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. 2020;12(8):e9742. Petejova N, Martinek A. Critical Care. 2014;18(3):224.

EMS 97

EMS Fluid Resuscitation Fractures Resuscitation 97

ACEP Now

MARCH 11, 2025

It may be tempting to administer crystalloid boluses to patients with eating disorders who appear to be dehydrated in the ED; however, this should be avoided because a common cardiac complication is heart failure. These tests are almost always normal in patients with eating disorders.

Emergency Department 83

Emergency Department Psychiatric Dehydration Pediatrics 83

EMDocs

NOVEMBER 4, 2024

Bhana, MD (EM Resident Physician, University of Massachusetts/UMass Chan Medical School); Clarence Kong, MD (Pain Fellow, Eastern Virginia Medical School – Virginia Health Sciences at Old Dominion University); Mani Hashemi, MD (EM Attending, HCA Florida Mercy Hospital); S.M. 2017.04.011 Witt CE, Bulger EM. Authors: Nikhil B.

Emergency Department 106

Emergency Department Fractures Burns EMS 106

Dr. Smith's ECG Blog

APRIL 8, 2015

Also consider non-hemorrhagic volume depletion, dehydration : orthostatic vitals may uncover this [see Mendu et al. (3)]. Premonitory symptoms (Nausea, pallor, diaphoresis, flushing), or triggers (Valsalva, Pain, Emotion, Prolonged Standing, Dehydration) are very useful in making the diagnosis. Vasovagal syncope is generally benign.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

Taming the SRU

NOVEMBER 18, 2024

Prolonged hiccups can also cause a myriad of negative health consequences including sleep deprivation, exhaustion, malnutrition, dehydration, and depression. He is a graduate from the UC EM residency, class of 2023. The physiology, etiology, and evaluation/management strategy of intractable hiccups remains poorly understood.

Stroke 86

Stroke Administration COPD Dehydration 86

Pediatric EM Morsels

FEBRUARY 2, 2024

PMID: 26368057 The post Travel-Related Illnesses in Children appeared first on Pediatric EM Morsels. Pediatric patients with recent travel and fever of unknown origin should be considered for admission if malaria is a possible diagnosis. Malaria requires 3 negative thick and thin smears over 12 hours to fully exclude. Pediatr Infect Dis J.

Infectious Diseases 164

Infectious Diseases Pediatrics Sepsis Documentation/Coding 164

EMDocs

JANUARY 20, 2025

For patients who are elderly, orthostasis is an unreliable clinical finding and may be present in the absence of dehydration. 36-37 There is little evidence regarding oral rehydration in adults with gastroenteritis, though it seems reasonable that adults with mild dehydration could be safely hydrated orally. Modified from: Pringle, K.,

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

EMDocs

JUNE 27, 2024

Sundd P, Gladwin MT, Novelli EM. smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 mg/kg, max 0.4 2020 Feb 12;10(1):2470. Annu Rev Pathol.

Pediatrics 97

Pediatrics Dehydration EMS Hospitals 97