Toxicology , Psychiatry

A Case of Lithium Toxicity Masked by Behavioral Symptoms in a Psychiatric Patient

5/6/2025 Rebecca Notini Kirby, MD , James O'Neill, MD , Jennifer Hannum, MD

Distinguishing between medical and psychiatric causes of altered mental status (AMS) can be challenging, as the two may present with similar clinical manifestations.1 As a result, patients with underl

Cardiology , Social EM , Ultrasound

Case Report: Arrhythmogenic Right Ventricular Cardiomyopathy Presenting with Inappropriate ICD Discharges

5/6/2025 Eytan Mendelow, DO , Daniel Patino-Calle, MD

The results of insufficient health care insurance and access can be seen most clearly in the emergency department. This case focuses on managing arrhythmogenic right ventricular cardiomyopathy (ARVC)

EMS , Wilderness Medicine , Trauma

A Self-Contained Hypothermic Rewarming System: A Case Study

5/6/2025 Conner W. Lynn , Skyler Hill-Norby, DO , Jennifer McGowan, MD

Hypothermia, one part of the deadly trauma triad, requires careful rewarming. This report reviews two cases of hypothermia presenting to resource-limited community sites, both managed via internal tem

Critical Care Alert , Critical Care , Resuscitation

Critical Care Alert: A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest

3/26/2025 Josh Wild, DO , Jacqueline Zhu, MD , Alexandra Hallagan, MD

Every minute counts for long-term outcomes in out-of-hospital cardiac arrest. Does the route of administration for lifesaving medications play a role? This EMRA Critical Care Alert dives into the PARA

EMS , Orthopedics

Severe Finger Entrapment in Gas Filler Cap Valve

3/23/2025 Robert Poth, DO , Courtney Merlo, DO , Andrew Park, MD , Akshay Srikanth, MD , Robert Klever, MD

How do you manage a case of a patient's finger stuck so completely in a Ford Explorer gas valve that EMS arrives with part of the vehicle attached to your patient? Hint: Consider the use of a nasophar

Vascular

Thoracic Outlet Syndrome as a Cause of Arm Swelling in Hemodialysis Patients: A Case Report

3/23/2025 Michael Yang, MD , Geoff Comp, DO, FAWM , Kimberly Mayekawa

Arm swelling in hemodialysis (HD) dependent patients is a serious complication associated with arterio-venous fistula (AVF) creation that is not often seen in the emergency department. We present a ca

Toxicology

A Case of Severe Lactic Acidosis Due to Metformin Toxicity

3/23/2025 Natalie Rech, MD , Sarah E. Fabiano, MD, FACEP, FAAEM

Metformin toxicity causes a profound lactic acidosis and can be concerning in patients with existing kidney impairment.

Infectious Disease , Pulmonary

A Case of Influenza A Encephalitis in an Adult with Addison's Disease

3/19/2025 Austeja S. Rubeski, OMS-IV , Brett Sweeney, MD

Physicians should recognize influenza encephalitis as a possible cause of altered mental status during influenza season. Furthermore, it is important to recognize Addison’s Disease as an increased ris

Career Planning , EMS , Prehospital and Disaster , Fellowships

It’s Time to Consider an EMS Fellowship

3/19/2025 Gregg A. Jones, MD, FAEMS

From hands-on and varied field experience to a deepened understanding of prehospital care and transition to hospital to your own response vehicle, reasons abound for EM residents to consider an EMS fe

Gastroenterology , Airway

The Bougie: Not Just for a Difficult Airway

3/19/2025 Kelcie Hill, MD

Up to 200,000 patients per year in the U.S. are given percutaneous endoscopic gastrostomy (PEG) tubes. A sizeable portion of those struggle with dislodged feeding tubes. A simple piece of airway equip

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