Can’t Miss Diagnoses Necrotizing Fasciitis Toxic Shock Syndrome Venous Thromboembolism (e.g. DVT) Peripheral Arterial Occlusion Abscess Tendon Rupture Cellulitis Burns (including chemical) Common Diagnoses: Sprains Strains Neuropathies IF CONSIDERING NEC. FASC. PLEASE USE PROPER PPE AND NOTIFY SURGICAL TEAMS EARLY. TIME IS TISSUE. Points to focus upon Hx To note and document; Tetanus status, anticoagulation, surgical manipulation if any.Ask about recent intercurrent febrile illnesses.May have “pain out of proportion” or localized hypoesthesia. Px: …

Can’t Miss Diagnoses Sepsis (obviously) – but critically important to find the source and control it! Meningitis / Encephalitis (Not to miss since may need LP for full diagnosis) Febrile neutropenia (especially if recent chemotherapy) Alcohol Withdrawal (hyperthermia, tachycardia, diaphoresis) Benzodiazepine Withdrawal (hyperthermia, tachycardia, diaphoresis) Toxic ingestions – cocaine, methamphetamines, crystal meth Thyroid Storm Serotonin Syndrome Neuroleptic malignant syndrome Points to focus upon Approximately 0.5% of ED visits are related to sepsis, with …

Can’t Miss Diagnoses Central Causes Cerebellar hemorrhage Stroke (especially posterior circulation) Vertebrobasilar insufficiency Multiple sclerosis Trauma Infections Peripheral Causes: Benign Paroxysmal Positional Vertigo (BPPV) Vestibular neuritis/ labyrinthitis Meniere’s Dz Infection: Acute otitis media Foreign body in the ear canal Vertigo Mimics: Syncope / Pre-syncope Hypoglycemia Dehydration Points to focus upon Hx: It is key to differentiate between peripheral (relatively benign, but extremely annoying) and central vertigo (possibly insidious and dangerous). See below chart …

Can’t Miss Diagnoses Intracranial Hemorrhage (ICH) – subarachnoid hemorrhage Traumatic ICH – Subdural hematoma, Epidural hematoma Increased ICP: Story of Shunt, malignancy, Cushing’s response Meningitis, Encephalitis Status Migrainosis Early COVID-19 may present with headache, myalgias (early viral symptoms) Cerebral Venous sinus thrombosis (CVST) Vascular: Temporal arteritis/Giant-Cell Arteritis, Carotid artery dissection Eye: Acute angle-closure glaucoma Carbon Monoxide (CO) poisoning Mnemonic for Dangerous Headaches BITE ME: B – Bleed (SDH, EDH, SAH)I – infectionT – …

Can’t Miss Diagnoses Unstable vertebral fracture Cord compression causing Cauda Equina Syndrome CES: Epidural abscess, hematoma Spinal Abscesses Discitis Killer Mimics: Vascular Aortic dissection, Ruptured aortic aneurysm Renal Pyelonephritis, renal colic Pneumonia Pelvic conditions Prostatitis, PID Red Flags of Back Pain Important to assess in DM, History of malignancy, anti-coagulation, osteoporosis, IVDU, steroid and immunocompromised states, and associated alarm symptoms like fever, syncope (aortic dissection). Here is a nifty mnemonic that may be …

Can’t Miss Diagnoses COVID-19 or other Viral Illnesses (Obviously) Anaphylaxis Pneumonia (PNA) Congestive Heart Failure (CHF) Acute Coronary Syndrome (ACS) Acute exacerbation of Asthma Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) Pulmonary Embolism (PE) Aortic Dissection Pneumothorax (PTx) Cardiac Tamponade Mimics due to high respiratory rate Diabetic Ketoacidosis Sepsis Points to focus upon Hx: Previous Seasonality / Patterns – to differentiate asthma from COVID-19, etc. Allergies or new allergic reaction precipitants (soaps, …