Brown Emergency Medicine Blog — BROWN EMERGENCY MEDICINE BLOG

Posterior Reversible Encephalopathy Syndrome (PRES) in the Emergency Department

68-year-old male with history of hypertension, chronic kidney disease presenting from home with wife at bedside for confusion and shaking movements. Per wife, the patient is independent at baseline. He walks, drives and still works. Yesterday, he complained of a mild headache and this morning she noticed he seemed more confused, described as asking repetitive questions and wandering around the house. Prior to coming into the emergency department, the patient had a one-minute episode of full body shaking. This has never happened before. He has no history of seizure activity. The shaking resolved on its own and the patient was very tired afterwards while awaiting the ambulance. ..

Community EM, Critical Care, NeurologyKatie MillerFebruary 19, 202355 Claverick StPRES, Hypertensive EmergencyComment

Postmortem Applications of Medical Imaging

A 50-year-old woman with a history of cancer with pulmonary metastases presented for outpatient lung biopsy. The biopsy was performed, and after the first specimen was obtained, the patient had massive hemoptysis requiring suctioning. Her blood oxygen level began to decline and a rapid response was called followed by a code blue…

Bob BarnoFebruary 6, 2023UltrasoundComment

Angioedema?

A female in her 30’s presents to the emergency department for acute onset of facial swelling, shortness of breath and a change to the sound of her voice. Although she denied any known allergic exposures, she self-administered an epi-pen at home with little improvement in her symptoms…

Emergency Medicine, ENT, PsychiatryKaitlin LipnerJanuary 30, 2023Emergency Medicine, Airway, PsychiatryComment

A Possible Role For POCUS in the Diagnosis of Calciphylaxis

Calciphylaxis is a life-threatening vasculopathy that results from the deposition of calcium in the arteriolar vasculature of the deep dermis and subcutaneous adipose tissue, which causes occlusion of the affected blood vessels and overlying tissues and skin…

Ultrasound, Dermatology, VascularBenjamin Gallo MarinJanuary 24, 2023Ultrasound, CalciphylaxisComment

Just My Puck: Posterior SC Dislocation Following a Hockey Game

An 18-year-old male with no significant past medical history presents with left shoulder pain after sustaining an injury while playing hockey. The patient reports that during the game he was tripped by another player, and subsequently hit the back board with his left upper torso. He immediately experienced severe pain and nausea. He was taken to the emergency department (ED) at this time. Pain is localized to the left shoulder, exacerbated by movement, and alleviated by immobilization. He denies shortness of breath, dysphagia, hoarseness, paresthesias, or any sensorimotor deficits…

Sports Medicine, OrthopedicsMaiya CowanJanuary 17, 2023Brown Emergency MedicineSC Dislocation, Orthopedics, Shoulder TraumaComment

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