Social Medicine in the Emergency Department: Not all conditions can be treated with medicines

By |Categories: Beyond the Abstract, Emergency Medicine|Tags: |

On the day we met Jane, a woman in her 70’s with diabetes and mobility impairment, she was visiting an Emergency Department (ED) for the 50th time in the past year. Jane was experiencing homelessness and spent much of her day riding public transportation in her wheelchair. Bystanders, often concerned for her health after noticing she had an episode of incontinence, would call 911 after which Jane would be brought to the nearest ED. On the day Jane came to our ED, our multidisciplinary ED-based Social Medicine team was asked to help in her care. She was very thin, her [+]

ACMT Toxicology Visual Pearls – A Poke in the Belly

By |Categories: ACMT Visual Pearls, Tox & Medications|

Which component of the pictured plant is the cause of gastrointestinal symptoms when ingested? Histamine Lectins Oxalates Ribosomal inhibiting proteins Saponin glycosides [+]

Caitlin Baldwin, DO

Caitlin Baldwin, DO

Emergency Medicine / Internal Medicine Resident
Jefferson Health - Northeast
Caitlin Baldwin, DO

Latest posts by Caitlin Baldwin, DO (see all)

  • Upper Extremity Bruising

SplintER Series: A Fateful FOOSH

By |Categories: Expert Peer Reviewed (Clinical), Orthopedic, SplintER, Sports Medicine|Tags: , |

A 66 year-old man presents with right anterior elbow pain, ecchymosis, and a “lump” in his right upper extremity after a ground level fall (Figure 1). What is your suspected diagnosis? What physical exam maneuver(s) can help you confirm your diagnosis? What is your initial workup in the ED? What imaging confirms the diagnosis? What is your management and disposition? Figure 1: Case Courtesy of Dr. Peter M. Martin   [+]

  • cdc gonorrhea chlamydia doxycycline

Doxycycline vs Azithromycin: Think Twice About the 2020 CDC Guideline Update on Treatment of Gonorrhea and Chlamydia

By |Categories: Genitourinary, Infectious Disease|

When the new Centers for Disease Control and Prevention (CDC) recommendations1 regarding the treatment of uncomplicated gonorrhea (and indirectly chlamydia) debuted like a slice of antibiotic resistance doom, it felt like another “gift” had arrived from 2020. Intramuscular (IM) ceftriaxone dosing has increased from 250 mg to 500 mg (or 1 g for weight ≥150 kg). Empiric chlamydia coverage switched from a single dose of 1 g of azithromycin to doxycycline 100 mg PO BID for 7 days. Being deferential to CDC expertise, many providers accepted them uncritically. Compliance rates with a switch from a 1-time to a 7-day regimen are not [+]

Free eBook Announcement: Emergency Medicine Resident Simulation Curriculum for Pediatrics (EM ReSCu Peds)

By |Categories: Pediatrics, Simulation|Tags: |

  The Emergency Medicine Resident Simulation Curriculum for Pediatrics (EM ReSCu Peds) is here! This free ebook contains 16 EM resident-tested, peer reviewed cases covering essential pediatric content identified through a robust modified Delphi process [1] with experts across the United States. Each chapter contains robust supporting materials to help educators prepare, execute, and debrief cases with residents at every level to help supplement the clinical experience. Download the EM ReSCu Peds eBook We request some basic demographic about you and how you plan to use the educational cases in the download form to provide us with necessary insights whether [+]

SAEM Clinical Image Series: What Lies Beneath?

By |Categories: Academic, Infectious Disease, SAEM Clinical Images, Ultrasound|

A 35-year-old male with a history of diabetes and pericarditis, status post pericardiectomy 3 years ago, presented with a painful lesion on his anterior chest wall. One month prior, the patient reported a bump at his sternotomy scar base which extruded a piece of suture when squeezed and subsequently healed. Two days ago, the patient developed diffuse right-sided chest pain. During the past 24 hours, an enlarging, erythematous, painful, non-draining lesion developed at the base of his scar. He reports subjective fever. He denies shortness of breath, exertional chest pain, nausea, and vomiting. [+]

SAEM Clinical Image Series: Left Ear Mass

By |Categories: Academic, ENT, Infectious Disease, SAEM Clinical Images|

A 25-year-old male who was previously healthy presents to the emergency department with a painful left posterior ear mass. The mass began as a “pimple” and has been increasing in size for the last 6 months. He has an associated headache, dizziness, and malaise. He denies fever, trauma, drainage, known insect bite, dysphagia, dyspnea, trismus, and hearing loss. He emigrated to the United States from Honduras 8 months ago. He was seen in the emergency department 4 months prior for a similar complaint, which was diagnosed as lymphadenopathy by point-of-care ultrasound. [+]

  • Calcaneus Fracture

SplintER Series: We’ve Got A Jumper

By |Categories: Expert Peer Reviewed (Clinical), Orthopedic, SplintER|

A 42-year-old patient is brought in by EMS after jumping off of a two-story building. The primary survey is intact and the secondary survey demonstrates swelling, ecchymosis, and tenderness to the right heel. You obtain foot x-rays and see the following images (Image 1. Lateral view of the right foot. Author’s own images).   [+]

Ashraf Hussain, MD

Ashraf Hussain, MD

SAEM Clinical Image Series: Blisters, Bullae, and Badness

By |Categories: Academic, SAEM Clinical Images|

A 3-year-old female with a history of epilepsy presents with a rash that began one day ago. The patient started becoming fussy four days ago, saying, “I don’t feel good,” and not wanting to play outside with her siblings or finish her meals. Family noticed the patient rubbing her eyes frequently and crying when she went to the bathroom. She felt warm so they gave her Tylenol and Motrin at home. Yesterday, they noticed a rash was starting to develop with itchy, painful red spots. This morning, the rash progressed to involve some blisters on the [+]

SAEM Clinical Image Series: The Hemorrhaging Bifurcated Tongue

By |Categories: Academic, Emergency Medicine, ENT, SAEM Clinical Images|

A 26-year-old male with no past medical history presented to the emergency department for tongue bleeding for one day. Five days prior he had an elective cosmetic tongue bifurcation completed out-of-state. About two hours prior to arrival, he had been using a swish-and-spit saltwater rinse when he felt a suture break. Ever since he has had copious bleeding, reportedly filling his sink at home with blood. Additionally, he had about 250 milliliters of blood, including large clots, in a container in the emergency department. He denied using any blood thinners. There was no syncope, dizziness, [+]

Shuhan He, MD
ALiEM Senior Systems Engineer;
Director of Growth, Strategic Alliance Initiative, Center for Innovation and Digital Health
Massachusetts General Hospital;
Chief Scientific Officer, Conductscience.com
Shuhan He, MD