60% of patients in the United States who develop severe sepsis are older adults (age 65 and over) , and the mortality of severe sepsis increases steadily with age to nearly 40% in those over 85 . There are many factors that make older adults more susceptible to sepsis, and that can also make sepsis more difficult to detect. Here are some tips to help explain why this is, and how you can identify it sooner.
We know that ultrasonography can be used to identify soft tissue infections. But what exactly are the distinguishing features between cellulitis and abscess? Is that a foreign body? Should I put a scalpel to this soft tissue infection? This PV card, written by Drs. Alissa Genthon, Patricia Henwood, and Mike Stone, serves as a great reference card for you at the bedside.
Case: A 55 year old female visiting the United States from southern Mexico presents with 6 months of chronic unilateral lower extremity swelling and 2 days of erythema. What is the most common cause of this chronic disease? Click on image for a larger view.
Spinal epidural abscess (SEA) is a rare but potentially catastrophic cause of back pain. Classically these patients are described as having back pain, fever, and clear neurologic deficits. In reality, patients often present with less obvious symptoms which often leads to a delay in diagnosis. Missed cases of SEA are a source of significant risk to both the patient and the provider. To improve outcomes and minimize risk, providers must identify and promptly evaluate patients who are at increased risk of developing a SEA.
Case: A 41 year old male with one week of non-pruritic palmar rash that started on his trunk and spread to his hands. He has no history of travel, fever, joint pains, or medication use. What is your diagnosis for this palmar rash? Click on the image for a larger view.
Welcome to the first ALiEM Approved Instructional Resources (AIR) Module! In an effort to reward our readers for the reading and learning they are already doing online, we have created an Individual Interactive Instruction (III) opportunity utilizing FOAM resources for US Emergency Medicine residents. For each module, the board curates and scores a list of blogs and podcasts. A quiz is available to complete after each module to obtain residency conference credit. Once completed, your name and institution will be logged into our private Google Drive database, which participating residency program directors can access to provide access.
Neuraminidase Inhibitors for Influenza – The Truth, The Whole Truth, and Nothing But the Truth Finally
Over the last 5 years, the use of neuraminidase inhibitors for the treatment of influenza has skyrocketed. Emergency physicians have been pushed to prescribe these medications under the belief that they reduced symptoms, the risk of complications, hospitalizations, and transmission. However, the recommendation for the use of these drugs has never sat on firm evidence-based ground. So what did we know then, and what do we know now?(more…)