Browsing: Clinical

Gastroenterology

Update on State-of-the-Art Imaging and Stool Tests for IBD in the ED

10/10/2022 Samuel J. S. Rubin, PhD , William W. Dixon, MD

For patients with IBD flare, maintain a broad differential diagnosis, promptly initiate appropriate workup for earlier intervention and better outcomes, obtain stool samples as early as feasible for l

ECG Challenge , Cardiology

ECG Challenge: October-November 2022

10/10/2022 Mary Voelker, DO , Jeremy Berberian, MD

A 68-year-old female with a past medical history of hypertension presents to the emergency department via private vehicle for recurrent intermittent episodes of unresponsiveness that started just prio

Toxicology

Buprenorphine Induction: Where We Are and Where We’re Headed

10/10/2022 Lance Shaull, MD

Buprenorphine has been shown to be a safe and effective medication in multiple settings with extensive research on both unobserved induction and physician-observed induction. Emerging evidence suggest

Pulmonary , Ultrasound

Real-Time Ultrasonography in Malignant Pericardial Effusion with Tamponade and Concomitant Pulmonary Embolism

10/10/2022 Kandria Ledesma, MD , Omar Amr, MD

In the setting of a malignant pericardial effusion with tamponade and pulmonary embolism, medical management can be difficult due the need for heparinization as well as pericardiocentesis. In a peri-s

Ophthalmology

BRAO and CRAO: Quick Diagnosis, Management Lead to Better Outcomes in Retinal Artery Occlusion

10/10/2022 Joshua McGough, MD, MS , William Hockett, MD , Armando Garcia, MD , Daryl Williams, MD

CRAO and BRAO are ocular emergencies mandating rapid diagnosis and management to prevent permanent loss of vision. Treatment options include ocular massage to attempt to relocate a lesion to a more pe

Op-Ed , Pediatric EM , Ultrasound

Yes, We Scan: Change Core US Requirements to Include Pediatrics

10/10/2022 Jenn Purcell, DO , Justin Hanson, DO , Jacob Pope, DO , Sarah Kleist, MD , Casey Wilson, MD

If pediatric abdominal ultrasound is routinely and deliberately taught to EM residents, a cultural shift away from obtaining abdominal CTs in children would be the desired outcome.

Ophthalmology

Tearful from Topiramate: A Case of Bilateral Secondary Angle Closure Glaucoma

10/10/2022 Kalee Morris, DO, MS , Cynthia Oliva, MD

Managing acute angle closure glaucoma in the ED involves decreasing intraocular pressure caused by excess aqueous humor. Once the diagnosis is made, steps can be initiated to rapidly decrease the pres

OB/GYN

Complications of Elective Medical Abortions

10/10/2022 Julia S. Marcus , Eric Wert, MD , MAJ John Kiel, DO, MPH, CAQ-SM

It is typical for a patient to have side effects after a medical abortion. Differentiating expected versus significant adverse events is crucial to providing proper treatment. Patient education prior

Cardiology

ST Elevation Myocardial Infarction in a Biventricular Paced Rhythm

10/10/2022 Priyanka Ravindran, MD , Rabia Iqbal, DO , Jason Kolb, MD

More studies are needed to create sensitive and specific criteria for coronary-related ischemia in patients with biventricular pacemakers, but high clinical suspicion, changes in EKG, and early recogn

Pediatric EM

Verapamil in SVT: No Need to Drop the Beat

10/10/2022 Gregory Wu, MD , Weston Christensen, MD, MMSc , Cecily Swinburne, MD, MPH

When a pediatric patient presents to the ED with pSVT and vagal maneuvers have failed, choice of AV nodal blocking agent is important. Our case shows that calcium channel blockers offer several advant