“Since the dawn of humanity, medical procedures have been used and are one of our species’ defining characteristics. …Various procedures and tinctures were used to ameliorate a wide range of pains and suffering, so it is no wonder that early medicine was also applied to resuscitating the dead.”
Read MoreAn unknown age male, estimated 30 years old, is brought into the emergency department by emergency medical services in cardiac arrest. He was found unresponsive on a park bench outside on a cold night. When EMS arrived he was noted to be very cold with no palpable pulse, spontaneous respirations, or response to sternal rub. A supraglottic airway was placed but they were unable to establish IV access. They performed 30 minutes of chest compressions and brought him to the emergency department on a LUCAS device…
Read MoreBy: Russell Prichard MD and Melanie Lippman MD
The patient is a 52 year-old female with a past medical history of hypertension, hyperlipidemia, hypothyroidism, and a 2 pack a day smoking history who presented to the emergency department in respiratory distress.
When EMS arrived to the patient’s home, she was hypoxemic with a pulse oximetry reading of 70s on room air and hypotensive with systolic blood pressures in the 80s. She was placed on nasal cannula with improvement in her saturations and she was given aspirin, fentanyl, and nitroglycerin without relief.
Upon arrival her vitals were significant for respiratory rate of 34, pulse oximetry of 98% on 6L NC. She was noted to be in acute distress.
The patient was placed on positive pressure ventilation via BiPAP and broad blood work, chest X-ray and electrocardiogram (ECG) were obtained.
Read MoreThe patient is a 5-year-old female with a past medical history significant only for torticollis who presented to the emergency department with fever, emesis, diarrhea, fatigue, and rash. The patient began having fevers to 102 degrees Fahrenheit five days prior to arrival. The patient’s mother reported that four days ago, the patient began having diarrhea and non-bloody, non-bilious emesis. Two days ago, she began having decreased PO intake, continued fevers and emesis, anuria, and bilateral neck pain. The morning of arrival, the patient’s mother noted a rash on the patient’s back and bilateral conjunctival injection. She brought the patient to her pediatrician’s office, who sent her to the ED for further evaluation and management…
Read MoreA 6-year-old female presents with emesis and fatigue. The patient’s mother reports her daughter has a history of Maple Syrup Urine Disease. The day before presentation, on routine urine check, the patient had 2+ ketones in her urine. The patient consumed a protein restricted diet, which initially cleared the ketones. However, on the morning of presentation, the patient began vomiting, appeared more lethargic and had 4+ ketones in her urine. On arrival, she was tachycardic and tachypneic. Her exam was significant for a tired appearing female with dry mucous membranes and poor skin turgor.
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