What’s Your Diagnosis? Seizures in Neonates: Diagnosis and Management in the Emergency Department
May 29, 2020


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Case Presentation: Seizures in Neonates: Diagnosis and Management in the Emergency Department

An EMS team brings in a 5-day-old boy with a history of a rhythmic, left-arm-shaking episode at home. The parents tell you the pregnancy was normal and the birth was a full-term, normal spontaneous vaginal delivery. The baby had been doing well until yesterday, when he started eating less and not waking up for feeds. The baby has low tone with a tense anterior fontanelle, and his temperature is 35.8˚C (96.4˚F). What workup is warranted at this time? read more

What’s Your Diagnosis? Acid-Base Disturbances: An Emergency Department Approach
May 29, 2020


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But before we begin, check out if you got last month’s case, on Novel 2019 Coronavirus SARS-CoV-2 (COVID-19): An Updated Overview for Emergency Clinicians right. read more

Stories From the Front Lines: Emergency Medicine Staff and the Fight Against COVID-19
May 6, 2020


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Stories From the Front Lines: Emergency Medicine Staff and the Fight Against COVID-19

Every night at 7 p.m., the streets of New York City, once cluttered with the noise of honking taxi cabs, buzzing crowds, and screeching trains, are now filled with a different sound—the sound of rhythmic chants and gracious applause. read more

What’s Your Diagnosis? Novel 2019 Coronavirus SARS-CoV-2 (COVID-19): An Updated Overview for Emergency Clinicians
April 28, 2020


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Case Presentation: An Evidence-Based Approach to Abnormal Vision

A 42-year-old man presents to your ED triage area with a high-grade fever (39.6°C [103.3°F]), cough, and fatigue for 1 week. He said that the week prior, he was at an emergency medicine conference in New York City, and took the subway with some people who were coughing excessively. The triage nurses immediately recognize the infectious risk, place a mask on the patient, place him in a negative pressure room, and inform you that the patient is ready to be seen. You wonder what to do with the other 10 individuals who were sitting near the patient while he was waiting to be triaged, and what you should do next… read more

Palliative Care in COVID-19
April 23, 2020


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Palliative Care Principles in the Age of COVID-19

By Ashley Shreves, MD

Most emergency clinicians are familiar with the guiding principles of palliative care, which focus on improving the quality of life for patients who are facing life-threatening illnesses. Palliative care uses a variety of mechanisms to ensure that patient values and goals are aligned with the medical treatment being given, while careful attention is paid to the patient’s pain and to the physical, psychosocial, and spiritual symptoms of the illness. I have been working in New Orleans as an emergency medicine and palliative care physician throughout the COVID-19 pandemic (except for the week that I had COVID-19 myself) and can share my observations about how palliative care principles apply to this patient population. read more

Risk Management Pitfalls for Management of Pediatric Patients With Tick-Borne Illnesses
April 16, 2020


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Tick-borne illnesses are increasing in prevalence and geographic reach. Because the presentation of these illnesses is sometimes nonspecific, they can often be misdiagnosed, especially in the early stages of illness. A detailed history with questions involving recent activities and travel and a thorough physical examination will help narrow the diagnosis. While some illnesses can be diagnosed on clinical findings alone, others require confirmatory testing, which may take days to weeks to result. read more

Emergency Medicine Staff and the Coronavirus (COVID-19) Pandemic: Practicing Mindfulness and Fighting Burnout During a Crisis
April 8, 2020


Posted by Robin Wilkinson in: Uncategorized , 2 comments

On an ordinary day, an emergency room can be an emotional and chaotic place. For the emergency medical staff who work there, life seems to move a lot faster and decisions are often made quickly and with limited information. The price of getting things wrong can mean the difference between life and death. read more

What’s Your Diagnosis? Identification and Management of Marine Envenomations in Pediatric Patients
March 25, 2020


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Case Presentation: Identification and Management of Marine Envenomation in Pediatric Patients

A 4-year-old girl with the chief complaint of rash is brought to the ED. Her family is on a beach vacation to the Florida coast for the summer. After exiting the ocean today, she complained of a “stinging” feeling on her chest and abdomen. Later in the afternoon, while changing her clothes, her father noticed a rash and brought her to the ED. read more

What’s Your Diagnosis? An Evidence-Based Approach to Abnormal Vision
March 25, 2020


Posted by Andy Jagoda, MD in: What's Your Diagnosis , 2 comments

Case Presentation: An Evidence-Based Approach to Abnormal Vision

A 40-year-old woman is brought in to the ED by her husband, complaining of blurred vision and dizziness. She said she had visited an urgent care clinic last week with a new diagnosis of migraine headache. Her examination is remarkable for right eyelid ptosis, limited movement of the right eye to left gaze, and a right dilated pupil compared to the left. read more

Test Your Knowledge: Failure to Thrive
March 24, 2020


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Emergency Medicine Practice Blog Brain Teaser

Failure to thrive (FTT) is a relatively common presentation in the emergency department. Up to 90% of cases of FTT have no identifiable cause and are categorized as nonorganic. Before deciding that FTT is nonorganic, it is imperative to consider and rule out organic causes. Identifying the underlying issues surrounding FTT is essential, as it will likely impact the treatment the patient receives. read more