A three-year-old otherwise healthy male presented with rash. The patient’s mother stated she noticed large, purple/red lesions on the patient’s lower extremities over the last week. They appeared to be itchy but not painful. The patient had URI symptoms a week and a half ago that had since resolved. For the last week he had not had any fever and has been behaving like his normal self. He intermittently stated “his belly hurt” but did not have any vomiting or diarrhea. Last bowel movement was the day prior and looked normal. The patient had no history of bleeding symptoms or family history of bleeding disorders. The patient was up to date on vaccinations. He had not taken or used any new medications, foods, lotions, detergents. Vitals were normal. Exam showed non-blanching lesions along the lower extremities without oral mucosal or genital involvement (Figure 1). There were no lesions on palms/soles. The upper and lower frenulums were intact without any signs of non-accidental trauma (NAT) on full body examination…
Read MoreThe old adage for Rhode Island’s ever shifting weather patterns goes, “if you don’t like the weather, wait 5 minutes.” The same can be said about the tax code Presidential administration to Presidential administration. As the country has experienced another change in the breeze, expect the seas to shift measurably. Will you be ready for the wind shift? Our navigator, Ms. Katherine Vessenes, JD, CFP®, RFC, Founder and President of MD Financial Advisors, is back to talk about what may be coming and how to be ready.
Read MoreAs students on an emergency medicine (EM) rotation work with different faculty on a daily basis, EM clerkships often incorporate an end‐of‐shift evaluation to capture sufficient student performance data. Electronic shift evaluations have been shown to increase faculty completion compliance. This study aimed to examine learner perceptions of their individualized feedback during an EM clerkship following the adoption of an electronic evaluation tool.
Read MoreA 48-year-old female with a past medical history of hypertension and hyperlipidemia and no past surgical history presented to the ED with constant, sharp, and burning epigastric pain. The pain started two weeks ago and was initially intermittent, centered in the epigastric region. Over the past day or so, the pain worsened and began traveling to the right side of her chest and around to the back. The pain was daily, usually after meals, and made worse by fatty foods. The patient felt slightly better after taking antacids. She reported the pain was 8/10 at worst, typically lasting several hours at this intensity, and receded to 3/10 at its best. She had some nausea but no vomiting. She denied changes in stool consistency/frequency or dark or bloody stools. She denied chest pain, sweating, or palpitations. She reported a subjective fever last night and into this morning, but no chills or change in weight. She had been compliant with her home medications.
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