Secondary hypothermia in patients with sepsis and trauma — Brain Teaser. Do you know the answer?
January 26, 2019


Posted by Andy Jagoda, MD in: Brain Tease , add a comment

Test your knowledge and see how much you know about treating and managing hypothermia and peripheral cold Injuries in pediatric patients.

Did you get it right? Click here to find out! read more

Using anti-D immune globulin in first trimest of pregnancy — Brain Teaser. Do you know the answer?
January 24, 2019


Posted by Andy Jagoda, MD in: Brain Tease , 1 comment so far

Test your knowledge and see how much you know about treating and managing first trimester pregnancies in the ED.

Did you get it right? Click here to find out! read more

Treatment Pathway for the Management of a Pediatric Patient With Hypothermia
January 19, 2019


Posted by Andy Jagoda, MD in: Uncategorized , add a comment

Hypothermia occurs when the core body temperature falls below 35ºC (95ºF) due to primary exposure (eg, environmental exposure) or secondary to other pathologies. Infants, children, and adolescents are at higher risk for primary cold injuries due to a combination of physiologic and cognitive factors, but quick rewarming and appropriate disposition can result in survival and improved neurological outcomes. Treatment for cold injuries is guided by severity and can include passive or active measures. read more

Treatment Pathway for Emergency Department Management of Nausea and Vomiting of Pregnancy
January 17, 2019


Posted by Andy Jagoda, MD in: Feature Update , 2 comments

Timely management of patients presenting to the ED while in their first trimester of pregnancy can improve outcomes for both the patient and the fetus. Common obstetric problems encountered include vaginal bleeding and miscarriage, ectopic pregnancy and pregnancy of undetermined location, and nausea and vomiting of pregnancy, including hyperemesis gravidarum. read more

Skiing with no gloves. How do you handle these cold injuries? — Management of Pediatric Hypothermia
January 14, 2019


Posted by Andy Jagoda, MD in: What's Your Diagnosis , add a comment

Case Recap:
A 17-year-old boy comes into your ED complaining of numbness and hardening of his fingers. He is a previously healthy foreign exchange student who is staying with a host family. The symptoms started yesterday after he went snow skiing for the first time. He says he wore gloves, but he was having a hard time holding the ski poles, so he took them off midway through the day. On examination, the fingertips on both of his hands are firm to the touch, have a dark discoloration, and are without sensation. The firmness and discoloration extend only to the distal interphalangeal joint in most of the fingers, but to the proximal interphalangeal joint in the middle finger of his left hand. The thumb on his right hand has a sizeable blister. As you step out of the room, you contemplate the next steps. read more

Intrauterine pregnancy presenting with fever. What do you do? — First Trimester Pregnancy Emergencies in the ED
January 12, 2019


Posted by Andy Jagoda, MD in: What's Your Diagnosis , add a comment

Case Recap:
Late in your shift, you evaluate a 26-year-old woman who has a confirmed intrauterine pregnancy at 11 weeks’ gestation and presents for fever, dysuria, and right flank pain. An ultrasound was performed in triage that showed bilateral mild hydronephrosis. read more

Skiing with no gloves. How do you handle these cold injuries? — Management of Pediatric Hypothermia
January 7, 2019


Posted by Andy Jagoda, MD in: What's Your Diagnosis , 3 comments

A 17-year-old boy comes into your ED complaining of numbness and hardening of his fingers. He is a previously healthy foreign exchange student who is staying with a host family. The symptoms started yesterday after he went snow skiing for the first time. He says he wore gloves, but he was having a hard time holding the ski poles, so he took them off midway through the day. On examination, the fingertips on both of his hands are firm to the touch, have a dark discoloration, and are without sensation. The firmness and discoloration extend only to the distal interphalangeal joint in most of the fingers, but to the proximal interphalangeal joint in the middle finger of his left hand. The thumb on his right hand has a sizeable blister. As you step out of the room, you contemplate the next steps. read more

Intrauterine pregnancy presenting with fever. What do you do? — First Trimester Pregnancy Emergencies in the ED
January 5, 2019


Posted by Andy Jagoda, MD in: What's Your Diagnosis , 18 comments

Late in your shift, you evaluate a 26-year-old woman who has a confirmed intrauterine pregnancy at 11 weeks’ gestation and presents for fever, dysuria, and right flank pain. An ultrasound was performed in triage that showed bilateral mild hydronephrosis. read more