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What is the role of POCUS to differentiate between cellulitis and abscess?

In Clinical Questions, Medical Concepts by Justin HsuLeave a Comment

A 30-year-old male presents to the ER with right forearm redness, swelling and pain. On exam, you are unsure whether this infection represents cellulitis or abscess. You wonder if point-of-care ultrasound (POCUS) can be helpful. Superficial soft tissue infections are a common ED presentation. Cellulitis appears as an area of erythema, edema and tenderness. An abscess is suspected when a discrete fluctuant mass is palpated within the infected tissue. However, relying on these …

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Tiny Tip: MORPH as a discharge guide for patients with substance use disorders

In Tiny Tips by Nicole MathiesLeave a Comment

Emergency Departments are often the primary source of healthcare for marginalized patients with substance use disorders.​1​ As such, we have unique opportunities to intervene and initiate change. While many acronyms and screening tools exist to identify substance use disorders, I have yet to find one that helps cover high yield items to be discussed with patients prior to discharge.​2​ In response, I created a clever, easy to remember tool based on case management …

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Vicious Cycles: Management of the Tricyclic Antidepressant Overdose

In Medical Concepts by Sophie RamsdenLeave a Comment

You’re on a night shift in the ED and receive a patch about a 75-year-old female with altered LOC. EMS reports an empty bottle of doxepin was found in her home. The patient is tachycardic and hypotensive, and on arrival has a GCS of around 12. You quickly look up the class of medication that doxepin belongs to, and realize it’s a TCA. What do you need to worry about in this patient, …

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Tiny Tips: Causes of Atrial Fibrillation

In Tiny Tips by Barrett GrattanLeave a Comment

Atrial fibrillation is the most common arrhythmia encountered and managed in the emergency department.​​1,2​ In addition to ensuring hemodynamic stability and subsequent management of the arrhythmia, the emergency physician must identify and treat potential underlying causes. Atrial fibrillation itself may be a sequela of an underlying life-threatening disease process such as pulmonary embolism or sepsis. In some instances, treatment of the underlying cause may lead to the resolution of the arrhythmia.​​1​ It is …

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FrontlineEM Primer: Human Trafficking

In Medical Concepts by Julianna DeutscherLeave a Comment

Management It is important to remember that our job as physicians is to determine if someone is at risk of being trafficked and then to facilitate connections to an interdisciplinary team and resources. It is not our responsibility to determine if someone meets the legal definition of trafficking and use only this as a measure of whether or not treatment and interventions are required.    Step 1: Identification of Red Flags The following list …