Author: Daniel Scholz, M.D. This is a Mayo Clinic Emergency Medicine Residency Interesting Case Presentation using the Pecha Kucha format http://youtu.be/OCHm4aZuroQ?list=UU8HKQ2hE8yml5Gfz2Ct3tYw Reviewers: Kharmene Sunga, M.D, Fernanda Bellolio, M.D. ...
Jeff Kline, from Indiana University, is the world's foremost expert in Pulmonary Embolism, particularly from an Emergency Medicine perspective. He has been quite active in #FOAMed recently through @klinelab. Below; there is a summary of two of his most recent tweets regarding the approach to the patient with suspected Pulmonary Embolism in the Emergency Department. This algorithms represent his perspective about the clinical problem.
Author: Sara E. Hocker, M.D. Assistant Professor of Neurology
A nursemaid's elbow is the easy way of saying radial head subluxation. The history is usually a toddler that is brought in because they will not use their arm. You will see them holding it in a flexed and pronated position usually with their hand sitting right over their belly button.
Author: David S. Morris, M.D. Assistant Professor of Surgery A patient comes into the emergency department with right upper quadrant abdominal pain. You have seen the patient and ordered all the tests. So, which patients with right upper quadrant pain should be seen by the surgeon in the emergency department?
Here are a few pearls about how to choose stress tests for patients presenting with CP that you’re admitting to the observation unit. Caveat #1: Much of this is specific to our observation at the Mayo Clinic. We have access to a multiude of provocative tests including EKG treadmills, Adenosine, Dobutamine, and exercise sestamibis, exercise and Dobutamine stress echocardiograms, cardiology consultations, and next day cardiology follow-up appoints. Caveat #2: This is not a discussion of the utility and evidence or lack-there-of for stress tests in low risk chest pain patients. Rather, during an emergency medicine residency and working in an emergency department with an observation unit, a resident will order a lot of stress tests as it is part of the practice of many Emergency Medicine Attending physicians. Given this, it is important to know some tips / tricks on how to select the most appropriate test.
1. What does the EKG below show? 2. What would be the key concerning Chief Complaint of the patient's presentation to the ED given this EKG? 3. What is your disposition/management plan if they present with the concerning chief complaint and this EKG? Answer/Explanation:
Recognition of anticoagulant use in the setting of intracranial hemorrhage, GI bleed, etc is important to note as it is associated with increased morbidity and mortality. We initiate immediate medical therapy to reverse anticoagulant effects in hopes of decreasing the severity of hemorrhage or promote hemostasis.
Author: Gabrielle J. Melin, M.D. Assistant Professor of Emergency Medicine The skill of assessing for suicide is one that all Physicians should possess. This is in essence a Psychiatric code. Asking about suicide does not make patients commit suicide; this has been shown over and over again in studies. Just like a cardiologist listens to the heart and a Neurologists checks reflexes on all patients, asking behavioral patients about suicide is essential at each encounter. Yes, even ask the 85 year old farmer. They have one of the highest suicide rates of all populations.
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