With the rise in popularity of the NOAC class of anticoagulants, more and more patients with a new diagnosis of pulmonary embolism are being discharged from the emergency department.  Multiple risk classifications tools have been developed to help identify patients at low risk of short term mortality. Read on to see if this new study determined which tool is the winner!

BACKGROUND:

-One segment of intestine telescopes into another

-Most commonly ileum into colon

-Most common cause of intestinal obstruction in children under 2 y/o

-Rare before 2 months old

CLINICAL:

-Classically infant with intermittent episodes of severe abdominal pain with legs drawn to chest, asymptomatic between episodes

-Classic Triad: abdominal pain, palpable sausage shaped abdominal mass, bloody stools (“currant jelly”)

- rarely all 3 present

Oral steroids are a mainstay of treatment for severe posion ivy induced contact dermatitis. The doses, duration of therapy, and taper/nontaper debate has raged for decades: read on a for quick summary of a paper comparing a short steroid burst to a 15 day taper!

A 38 y.o male presents with complaint of extremity pain.  During your examination and differential, you become concerned for necrotizing fasciitis.  Here are some clinical pearls!