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One Emergency Medicine Resident. One Month of Palliative Care. Ten lessons.

In Medical Concepts by Brittany Ellis1 Comment

As emergency medicine residents, we work side-by-side with a wealth of specialities to gain clinical and diagnostic skills and to learn what happens to our patients when they leave the ED. We strive to distill the information we need to make ourselves better clinicians and improve the transition of patients from the ED to inpatient teams. However, only rarely do we get to see where our patients came from, what happened prior to …

The Use of the Modified Valsalva Maneuver for Stable SVT

In Medical Concepts, Tiny Tips by Paula Sneath0 Comments

Please note that, while “supraventricular tachycardia (SVT)” is a term that can be used more broadly to refer to any tachyarrhythmia originating above the ventricles, I use its more conventional meaning here to describe AVnRT and AVRT. LITFL has a good summary of narrow-complex tachycardias. SVT is a narrow complex tachycardia commonly seen in the emergency department. In hemodynamically stable patients the first-line treatment is vagal stimulation, usually the Valsalva maneuver. However, success …

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The Long and Short of Needleless IV Extension Sets

In Case Series, Featured by Riley Hartmann0 Comments

While working nights with an EMS crew, you arrive on scene to find a 24 year-old male who was thrown from his vehicle at highway speeds. You estimate that there was 1500 mLs of blood loss visible on the road, with active bleeding from his left femur and abdominal guarding. After applying a C-spine collar, a pressure dressing, and moving him into the back of the ambulance, you start an 18 gauge IV …

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Spot the Diagnosis! The case of the Jovial Man

In Arts PRN, Medical Concepts by Tetyana Maniuk1 Comment

As part of the Arts PRN series, we will intermittently be featuring pieces of historic art that hint at an underlying medical condition. They say a picture is worth 1000 words… can you Spot the Diagnosis after examining only a painting? Read on to learn not only about the art, but about these fascinating medical conditions. Who knows, maybe they’ll help you make a diagnosis some day (or at least help you out on Jeopardy)! …

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Tiny Tips: “SNOOP MEETS Pregnancy” Headache mnemonic

In Medical Concepts, Tiny Tips by Sean Patrick0 Comments

Many must-not-miss diagnoses manifest as a secondary headache. Though the DDx list is quite large, the pertinent questions that must be asked on history can be remembered using the mnemonic “SNOOP MEETS Pregnancy”1,2 Below you’ll find the cues associated with each letter, the symptoms they are associated with, and the differential diagnosis for some of those symptoms. Systemic symptoms = fever, night sweats, weight loss, loss of appetite, protracted vomiting DDx: Meningitis, Encephalitis, Systemic infection, Lyme …

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Clinical Question: Can Ventolin improve wheeze in heart failure?

In Clinical Questions, Medical Concepts by Ponn Benjamin0 Comments

A 70-year-old male calls EMS with a 3-day history of shortness of breath. He sleeps in a chair because his breathlessness is made worse while lying on the flat of his back. He is working hard to breath and has difficulty speaking in full sentences. Physical examination reveals an elevated JVP, a third heart sound, and wheezes bilaterally with fine inspiratory crackles. He also has bilateral pitting edema to his hips. Vitals include a …