Blunt chest injury can rarely result in a direct contusion to the myocardium. This "bruise of the heart" can precipiate lethal cardiac arrhythmia, often in a delayed fashion. As you evaluate a trauma patient with complaints of chest pain after blunt injury, yo you wonder what the correct workup and management of this potentially fatal condition should consist of....
A 50 yo male is brought in via EMS vomiting red fluid. 1 hour prior, he had chugged about half a gatorade bottle that he had used to store windshield washer fluid. "What's in windshield washer fluid?" you wonder as you enter the patient's room. "Is it bad????" Read on to find out why, yes, this is very bad indeed.
A 59 year old male presents complaining of unsteadiness on his feet and vomiting for 24 hours. You know there are numerous benign explanations for his symptoms, but also realize there are a few "can't miss" diagnoses as well...what are they and how do we assess for them in the ED?
A 56 yo male with a hx of TBI, subglottic stenosis, tracheomalacia, and tracheal stenosis presents in acute respiratory distress. There is a strange looking trach in place with no balloon for a cuff. You begin to wonder how you will manage this pt if he ultimately requires mechanical ventilation.....
You are evaluating a patient for abdominal pain the usual way (with a CT of course!) when you discover an incidental pericardial effusion. Quick as a flash you grab your trusty ultrasound and head back to the patient's room, wondering how this effusion got there and what POCUS findings you should be looking for...
A 56 year old male presents to the ED with confusion and abdominal pain. You notice a fistula in his upper extremity. A tech hands you his triage ECG and you scrutinize it for the tell-tale signs of a common, life-threatening diagnosis in hemodialysis patients, while wondering what the initial steps in management are....
A 41 yo male is brought in by EMS after self inflicted stab wounds to the neck and chest. As the patient is transferred to the ED stretcher, you frantically try to recall the initial priorities in the management of this potentially deadly injury....
You are evaluating a patient with the sudden onset of palpitations. You note a regular, narrow complex tachycardia at a rate of 160 bpm and suspect a reentrant tachycardia. You think "adenosine" but secretly wonder if there is a better option, or what you'll do if this fails....
As with most complaints in Emergency Medicine, headaches are usually benign and self-limited conditions. Occasionally, however, the etiology can be potentially devastating, particularly in post-partum patients...
A 25 yo female presents with a complaint of abdominal cramping and heavy vaginal bleeding. This is a routine complaint in the Emergency Department and rarely represents a life-threatening emergency....until it does...
