Sun.Feb 11, 2024

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SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Syndrome in the ED.

The Skeptics' Guide to EM

Reference: McLatchie et al and DAShED investigators. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. EMJ Nov 2023. Date: February 11, 2024 Guest Skeptic: Nirdosh Ashok Kumar, Emergency Medicine Specialist – Aga Khan University Hospital, Karachi, Pakistan. […] The post SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Sy

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Dear Colleagues. Wake Up, You Are Being Used

Stop and Think

I really don’t like scolds. I have hesitated to write this short piece because it makes me seem like a scold. But I can’t help myself. This week I saw on my Facebook feed a picture celebrating the 500th implant of a preventive cardiac device. The picture featured smiling doctors and super-happy industry reps. The writer expressed happiness that they had helped so many people.

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See What PM Cardio Digitization can do with this ECG

Dr. Smith's ECG Blog

This was a patient with chest pain. The ECG was faxed to a cardiologist. But it was very difficult for him to see. He showed this to me the next day.

EKG/ECG 61
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How To Perform an Ultrasound-Guided Clavipectoral Block

ACEP Now

The clavicle is one of the most commonly fractured bones in the human body. Every year, approximately 332,000 people in the United States suffer from a clavicular fracture. 1,2 In the emergency department (ED), the focus of treatment is pain control and immobilization unless there is a clear indication for surgery, such as open fractures, skin tenting, or neurovascular compromise. 1,2 The mainstay of pain control in the ED has been either oral or intravenous non-steroidal anti-inflammatory drug

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Papilloedema

Mind The Bleep

Introduction Papilloedema is optic disc swelling which is specifically secondary to raised intracranial pressure (ICP). It is nearly always bilateral and can be asymmetrical. [1] The umbrella terms disc swelling, or oedema include unilateral or bilateral disc involvement with varying causes and not only raised intracranial pressure. [1, 2] This article will specifically focus on papilloedeoma, its pathophysiology, causes, clinical features, investigations and management.

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FACEPs in the Crowd: Dr. Matt Astin

ACEP Now

When attending Mercer University in Macon, Ga., ACEP Fellow Dr. Matt Astin got his best friend to join him on the cheerleading team … but there was a condition that ultimately put Dr. Astin on center stage. “He said he would try out for the team if I auditioned for the spring musical. Not sure who lost that bet,” Dr. Astin joked. “We were cheerleaders for three years and coached Mercer for two.

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How Can I Remember the Progression of Gesell Figures?

Pediatric Education

Patient Presentation A 3-year-old male came to clinic for his health supervision visit. He was happy to see his doctor and gave him a picture as well. “See that is you and that is me,” he says proudly pointing out two circles among what appeared to be individual lines and scribbles. The pertinent physical exam showed a smiling preschooler with normal vital signs and growth parameters around the 50%.

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Case Report: A Sneaky Culprit for Altered Mental Status in Elderly Patients

ACEP Now

A 95-year-old female with a history of stage III chronic kidney disease (CKD), heart failure with reduced ejection fraction (HFrEF), and dementia with baseline orientation only to person and place, presented to the emergency department (ED) for upper extremity myoclonic jerking for one day. Her review of systems upon initial presentation was negative other than for a dry cough.

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Popular Antiobesity Medications Bring New Challenges to Emergency Physicians

ACEP Now

On a busy emergency shift, you have a series of patients with atypical presentations. Your first patient, Patient A, is a 38-year-old female with a distant history of anorexia nervosa, presenting with persistent, diffuse, abdominal pain, nausea, intractable vomiting, inability to tolerate oral intake, and fatigue for four days. She experienced a syncopal episode at work today.

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By the Numbers: Leishmaniasis

ACEP Now

ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.

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Case Report: Cutaneous Leishmaniasis in Chicago

ACEP Now

A 25-year-old Venezuelan male presented to a Chicago area emergency department (ED) in early November 2023. He had traveled with his family through Panama, Costa Rica, Nicaragua, Honduras, Guatemala, Mexico, and Texas before arriving in Chicago approximately one month prior to his ED visit. He noted spending about five days walking through a jungle, as well as traversing rivers.