Mr. S is a 68 year old man who presents to the emergency department with maroon stools and weakness for one day. He appears diffusely weak, diaphoretic, and pale. The tech is struggling to get vital signs while the nurse is working on placing two large bore IVs. After a minute the tech gives up - “I can’t get a heart rate or a blood pressure, doc.” With another quick glance at the (obviously still living) patient, you notice a battery pack at his side. This is followed quickly by the realization that the patient has a Left Ventricular Assist Device (LVAD)…
Read MoreA 22 year-old female with a medical history of migraines and obesity who presents to the Emergency Department with a headache. Her headache was gradual in onset, but has progressively worsened and has not been relieved with NSAIDs. She describes the headache as dull and pounding with photophobia and phonophobia. She also notes associated nausea but no vomiting, and no associated neurologic complaints. She does note that she thinks during a previous ED visit at an outside hospital she was told she may have “high pressure in her head” but she does not remember the details and is not on any medication for it…
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