A 70 year-old woman presents to the ER with mid-sternal chest pain, shortness of breath, and diaphoresis. She's clutching her chest with her fist. There is isolated ST elevation in aVR and inferolateral ST depression. That's a STEMI! Or is it?
Fluoroquinolone antibiotics (Ciprofloxacin, Levofloxacin, Moxifloxacin, among others) are an important class of antibiotics that are used in a variety of settings. Ciprofloxacin remains one of the primary treatment options for cystitis. It is used routinely for inpatient treatment of pneumonia and many still consider it part of the first-line treatment for diverticulitis. But in the last few years, questions about its safety profile have led to growing concerns.
Managing the Emergency Department is a team sport. That means sharing information with one another, trusting your teammates to perform to the best of their ability, and working together towards a common goal. To that end, one responsibility of [most] ED physicians is supervising mid-level providers.
Cervical arterial dissections most commonly occur in the carotid arteries, followed by the vertebral arteries. Vertebral artery dissection (VAD) often presents after a trivial injury such as hyperextension of the neck while at the salon...
Myasthenic crisis is a rapidly progressive and potentially fatal condition. Early consideration and bedside confirmatory tests are essential. Have a low threshold to establish a definitive airway using higher than typical doses of paralytic medications. Involve the consultant early and be extra vigilant when caring for anyone with a history of myasthenia gravis
When evaluating a patient, we rely on a good history to help us form a differential diagnosis. We use our physical exam skills to refine that list. A bedside ultrasound or ECG can further guide our decision-making and save precious time. Beyond these, we rely on seemingly failsafe data: radiographs, blood tests, and urine samples. But sometimes these reliable tests aren't so reliable.
As disease patterns evolve, so too must we. Being aware of emerging illnesses and remaining diligent in identifying their presence ensures a safe environment for the patient and the community. Measles is a highly contagious and potentially lethal viral infectious disease.