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EM@3AM: Stercoral Colitis

EMDocs

Well keep it short, while you keep that EM brain sharp. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days. Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management.

EMS 94
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ToxCard: Iron

EMDocs

Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. 5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Basic assessment: airway, breathing, circulation. Antiemetics as needed. 2 L/hr in adults.

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EM@3AM: Retroperitoneal Hematoma

EMDocs

We’ll keep it short, while you keep that EM brain sharp. A 25-year-old man presents to the ED via EMS after he sustained a gunshot wound to the left flank. Vital signs include BP 90/48, HR 122, T 98.3 F, RR 16, SpO2 97% on room air. On examination, he has a circular wound, marked tenderness, and ecchymosis to the left flank.

EMS 93
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emDOCs Revamp: Esophageal Perforation

EMDocs

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

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The SQuID Protocol: SQ Insulin in DKA?

RebelEM

Background: DKA is traditionally treated with fluid resuscitation, electrolyte replacement, and intravenous infusions of insulin. The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. appeared first on REBEL EM - Emergency Medicine Blog. Paper: Griffey RT et al.

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Grand Rounds 5.8.24

Taming the SRU

r1 clinical knowledge - r4 capstone - research grand rounds - the art of em - Community corner - PEM Lecture r1 Clinical knowledge: transplant complications WITH dr. gabor Time-sensitive peri-transplant emergencies: Bleeding fistula- stop the bleed. Flood syndrome- start fluids, give antibiotics, consult surgery.

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Case Report: a High-Voltage Victim

ACEP Now

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. Per EMS, the patient was found at the bottom of a high voltage line with diffuse burns and amputation of his left forearm.

Burns 52