Left ventricular assist devices (LVADs) have moved from being a bridge to a heart transplant to destination therapy for patients with severe heart failure. Although their use in the general public has increased, they still provide a challenge to the emergency medicine (EM) physician. This series aims to cover the basics of how the EM physician approaches the care of these patients.
A 32 year-old male presents to the Emergency Department after he felt a “pop” in his posterior-medial calf while playing tennis. He was able to ambulate but had pain with plantar flexion and was unable to continue playing tennis. What is your differential diagnosis? What physical exam maneuver would you perform? What findings would you expect on physical exam? What is the diagnosis based on ultrasound images? What is your management in the emergency department?
Left ventricular assist devices (LVADs) have moved from being a bridge to a heart transplant to destination therapy for patients with severe heart failure. Although their use in the general public has increased, they still provide a challenge to the emergency medicine (EM) physician. This series aims to cover the basics of how the EM physician approaches the care of these patients.
A 35-year-old female emergency medicine physician presents for evaluation for severe myalgias, headache, fatigue, mild nasal congestion, profound anosmia, cough, and subjective fevers and chills. She has no measured temperature above 100.4°F, but has been taking anti-inflammatories around the clock. The day previously, she called occupational health and received testing for the novel coronavirus. The next day, her test returns positive. What happens next? We are here to share our personal experiences with COVID-19 and provide some resources to best support yourselves, your families, your learners, and your colleagues throughout this uncertain and ever-changing situation.
Given overcrowded hospitals and limited availability of personal protective equipment (PPE), showing up for work can feel like entering a battleground without ammunition for many physicians during the COVID-19 outbreak [1]. Despite this, doctors and nurses show up every day ready to do their jobs. While we have committed to the Hippocratic Oath, our families have not. How can we do our duty while preventing exposure of our loved ones at home [2, 3]?
Your team in the Emergency Department (ED) receives a call from your local Emergency Medical Services (EMS) crew informing you that they are transporting a patient with high suspicion of COVID-19 in severe respiratory distress. As you assemble your team in preparation for a Protected Code Blue (PCB), your staff (including physicians, nurses, respiratory therapists, etc.) begins donning full Personal Protective Equipment (PPE). PPE includes donning a gown, gloves, face mask, goggles and/or a face shield.
With several team members assembled in the resuscitation bay in full PPE, it can be challenging to identify specific individual members of the team and their role.
With so much appropriate attention focused on getting frontline emergency providers with personal protective equipment in the COVID-19 era, one major overshadowed storyline is the uncertainty of the 2020-21 interview season for medical students applying into Emergency Medicine (EM). COVID-19 has thrown a wrench in the entire application season not only for medical students, but also medical schools, residency programs, and hospitals. The downstream effects of potentially canceling visiting (away) EM rotations and possibly even home EM rotations in the near term are dizzying. How does one obtain enough letters of recommendation? Should I even apply for visiting EM rotations? Fortunately, an experienced panel of EM program directors joins Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF) in discussing the thought processes, ongoing nuanced discussions, early available resources, and general mindset for the 2020-11 season.