Brown Emergency Medicine Blog — BROWN EMERGENCY MEDICINE BLOG

Health Inequity and Social Emergency Medicine

A thin 27-year-old male with no known past medical history presented to the ED for evaluation of 3 days of fever and several weeks of fatigue. Associated symptoms included nausea, diarrhea, and a 15 pound weight loss. On further questioning, the patient reported food and housing insecurity. He stated he was living at a bathhouse and had multiple male sexual partners in the past month. He smokes cigarettes and endorses occasional alcohol and drug use. He stated that he has no source of income or cell phone, and reported being estranged from many family and friends…

Health Equity, Social EMNichole MichaeliJune 24, 2022Social Determinants of HealthComment

Arthrocentesis of the Ankle: Video

ProcedurettesNick MusiscaJune 21, 2022Comment

Unresolved UTI: The Search For a Prompt Diagnosis

A 14-year-old female presented to the emergency department (ED) with persistent left upper quadrant (LUQ) pain. She was last seen in the ED one week prior for similar symptoms. Initially, she was diagnosed with a urinary tract infection (UTI), treated with IV ceftriaxone, and discharged home on a course of cefdinir. On re-presentation, she complained of persistent LUQ pain, fevers with a Tmax of 103 F, and one episode of emesis overnight. Physical examination revealed abdominal tenderness in the LUQ, without ipsilateral CVA tenderness…

UltrasoundBrian DruryJune 17, 2022Ultrasound, PyelonephritisComment

Red, Hot, Legs: Thrombophlebitis of the Superficial Veins of the Lower Extremity

A 34-year-old female with medical history notable for varicose veins presents with complaint of left medial thigh pain. The patient states the pain started 3 days ago. She denies any fevers. She states the area is very painful to the touch. No antecedent trauma or injury. She has been taking Tylenol with minimal relief. She has a remote history of varicose vein ablation to her left leg..

Community EM, DermatologyMichael TcheyanJune 10, 2022Thrombophlebitis, DermatologyComment

“Gotta Go Right Now”: Use of Whole Bowel Irrigation in the Treatment of Lithium Toxicity

A 30-year-old female with a history of bipolar disorder presented after intentional lithium overdose. The patient reported feeling increasingly depressed for several weeks with intermittent suicidal thoughts. She reported getting into a verbal altercation with family while drinking alcohol and subsequently ingested a nearly full bottle of lithium (approximately 40 tablets, each with a concentration of 300 mg). She reported mild blurred vision and anxiety, but otherwise denied any other subjective complaints…

Community EM, ToxicologyMichelle MylesJune 3, 2022Toxicology, Lithium OverdoseComment

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