An ex-full term six-week old male presented to the pediatric emergency department with three weeks of forceful, non-bloody, non-bilious emesis. He was having two to four episodes of vomiting that occurred after feeding. Three weeks prior, the patient had been transitioned from breast milk to formula, and attempts to thicken the formula by adding rice had not improved his vomiting. More recently, he had poor PO intake and his parents were concerned about his weight. He had no fevers, no change in number of wet diapers or stooling, and no other acute complaints…
Read MoreThere may be a time when you don’t *gasp* have an x-ray machine. Osteophony is a 19th century technique by which practitioners would use the acoustic properties of intact versus disrupted bone to determine if there was a fracture or dislocation. Extra points if you can get orthopedics to come see the patient based solely on osteophony!
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A middle-aged male presented in cardiac arrest. He had reportedly complained of preceding chest pain. Upon EMS arrival, his presenting rhythm was ventricular fibrillation (VF), which was refractory to multiple attempts at defibrillation. After receiving treatment for refractory VF, the patient had return of spontaneous circulation (ROSC). He was hypotensive, and ultimately required triple pressor support to maintain adequate mean arterial pressure. An initial electrocardiogram (EKG) was performed, which showed sinus tachycardia. A repeat EKG was performed one hour later, showing…
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