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, [+]

SAEM Clinical Image Series: Shortness of Breath

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

A 60-year-old female presented to the emergency department (ED) for respiratory distress. Emergency medical services reports that the patient was in respiratory distress upon arrival, slowly becoming unresponsive en-route. They started the patient on continuous positive airway pressure, but she lost consciousness with oxygen saturation in the thirties and they switched to bag valve mask (BVM) ventilation, which improved saturations up to 100 percent. Narcan was administered without improvement as she was on narcotics following bronchoscopy earlier today at an outside hospital. [+]

SAEM Clinical Image Series: Oral Trauma and Mass

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

A 38-year-old African American male without a significant past medical history presented with an oral mass. He was struck on the mouth by a wrench handle about two prior. Since then he has had a growing mass originating from the gum of his left front upper teeth. He is no longer able to eat solid foods and has to use a straw for all oral intake. The patient denies fevers, chest pain, shortness of breath, and weight loss. [+]

  • Posterior tibiofemoral arthroplasty dislocation

SplintER Series: My Knee, Again!

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

A 61-year-old F presents to the ED from the orthopedic clinic with acute right knee pain. She endorses that while a physical exam was being performed, she had sudden onset knee pain. Denies any trauma to the knee, radiation of pain, numbness, tingling, or swelling. The above knee radiographs were obtained (Images courtesy of John Kiel, DO).   [+]

ACEP E-QUAL: ACEP Non-STEMI Clinical Policy

By |Categories: Academic, ACEP E-QUAL, Cardiovascular|

In 2018, the American College of Physicians (ACEP) released a Clinical Policy with management recommendations for patients presenting to the emergency department (ED) with concern for non-ST-elevation myocardial infarction (NSTEMI). Dr. Jason Woods hosted an episode of the ACEP E-QUAL Network podcast highlighting key aspects of the new policy. Dr. Woods was joined by lead writer Dr. Christian Tomaszewski from the University of California San Diego, and Dr. Michael Ross, Director of the Chest Pain Center at Emory University. Below are show notes reviewing the recommendations and the process involved in creating the clinical policy.      How is a [+]

ACEP E-QUAL: The Electronic ICU

By |Categories: Academic, Critical Care/ Resus, Podcasts|

  Building on already increasing interest in telehealth, the COVID-19 pandemic accelerated the development and implementation of telemedicine services in a variety of clinical settings. In 2018, Dr. Jason Woods hosted an episode of the ACEP E-QUAL Network podcast highlighting the creation of an electronic intensive care unit (eICU) through Emory Healthcare. In this episode, Dr. Tim Buchman and Critical Care Nurse Cheryl Hiddelson share their innovative approach to delivering critical care services via telehealth. We present highlights from this discussion below.     What is an eICU? The eICU allows for critical care oversight, without having to be on site. [+]

Buprenorphine prescribing: The Get Waivered Initiative makes it easier to get your DEA-X Waiver

By |Categories: Podcasts, Tox & Medications|Tags: |

A major development in curbing the opioid epidemic is the introduction of the medication buprenorphine to address opioid addiction. Being able to prescribe this medication, however, requires a special DEA-X Waiver in the United States. Dr. Alister Martin, the Founder of the Get Waivered initiative, is working to reduce the barriers for clinicians to obtain the training and paperwork necessary to obtain this waiver. Dr. Michelle Lin talks with Dr. Martin on this podcast about the backstory of the Get Waivered program, the lowered barriers to obtaining training, and some sneak peaks on what is new on the launching pad [+]

SAEM Clinical Image Series: Eye Pain After Assault

By |Categories: Academic, Emergency Medicine, Ophthalmology, SAEM Clinical Images, Trauma|

A 33-year-old male presents with intermittent blurry vision and left eye pain for 3 months, and a left-sided orbital headache for 1 day. He reports getting punched in the left side of the head during an altercation a few months ago. The eye pain is worse with ocular movements and is associated with bilateral conjunctival injection and white/green discharge from the left eye. The patient was seen at another emergency department 3 months prior for the same symptoms. He was then found to have left-sided proptosis, visual acuity 20/60 in the left eye, no fluorescein [+]