EM physicians see patients with headaches every day in the ED. The vast majority have a simple primary headache, but a tiny fraction of patients will have a much more serious etiology that might result in death, blindeness, or crippling neurologic complications if not promptly diagnosed. The trick, of course, is picking up on the serious causes of headaches...
A 69 year old man is brought in by EMS with complaints of chest pain. ALS noted pt to be in sinus bradycardia in the 30s en route. As you approach the room you wrack your brain: what are the common causes of bradycardia? More importantly - will I get to actually perform a transvenous pacemaker i.e. the most highly sought after procedure as an emergency medicine resident?
History: A 64-year-old woman presents to the ED via EMS after a witnessed seizure lasting less than 1 minute. The patient appeared post-ictal for EMS but is currently alert and oriented. She does not recall what happened.
An 87 yo male is brought in by EMS after a syncopal event while on the toilet, resulting in a fall and head injury. EMS reports a heart rate in the 30s en route. As your approach the resuscitation bay you begin to think about the causes of bradycardia and what your approach will be to stabilize this potentially very sick patient....
You are called to the trauma bay to evaluate an 18 yo male involved in an MVC. Your nurse tells you that he seems ok but keeps repeating himself. You wonder what injuries you should be concerned for and what your diagnostic approach should be as you enter the patient's room.....
EMS brings in a patient who was found down in his front lawn. They report he is dry and very hot to the touch, and has been unresponsive during transport. As you approach the resuscitation bay you quickly run down potential causes of a heat emergency and begin to think about the best way to treat this patient.....
The overwhelming majority of patients with back pain have a benign etiology and require nothing more than pain control and time to recover fully. A good emergency medicine physician, however, should always keep in mind the "can't miss" diagnoses and take a careful history focusing on "red flag" symptoms and risk factors. Failure to make the diagnosis in our patient today would result in irreversable paraparesis, incontinence, and impotence. Read on to see why!
A healthy 23 yo male presents after injuring his knee playing soccer. He is complaining of inability to completely extend his knee. "It's stuck." he reports to the triage nurse. "That seems like a problem..." you think to yourself as you enter the room. How did this happen? How do I unstick his knee? Read on for some quick pearls on the "locked knee."
Do you feel like you pour your heart, soul, blood, sweat, and tears into your fracture/reductions and still come up short? Does the orthopedics consultant always want to "re-do" your attempt? Here is a repost of a podcast interview between former Cooper EM resident Patrick Sheehan, former Cooper Orthopedics Resident Joseph Legatol on how to get a perfect reduction. Inside the interview are 5 tips on positioning yourself for success. Also included is a video of Dr. Sheehan giving an example of "exaggerating the injury" of a distal radius fracture for a more successful reduction.
