Case: A 51-year-old woman presents to the ED with the chief complaint of left leg swelling. She recently underwent bunion correction surgery to her left foot 7 weeks ago, and her cast was removed one week ago. Over the last day or two she has had significantly increased leg swelling and more recently reports some dull pain described as” heaviness” to the affected leg. The patient denies chest pain, shortness of breath, or …
Clinical Question: What is the best treatment for acute dyspepsia?
The Case: Tummy Ache? Piece of Cake! A 26-year-old woman presents with epigastric pain after consuming a large piece of cake. She describes that she had previously been diagnosed with heartburn by her family doctor and was on a heartburn medication but stopped taking it when she went on vacation. She denies associated chest pain, shortness of breath, and changes in bowel habits. She describes the pain as a 7/10 sharp stabbing pain. She is otherwise …
Clinical Question: How useful is the β-HCG discriminatory zone in a suspected ectopic pregnancy?
For female patients presenting to the emergency department with a positive serum β-HCG as well as abdominal pain, vaginal bleeding, syncope, or hypotension, the prudent emergency physician must rule out an ectopic pregnancy (EP). This potentially life-threatening entity is estimated to occur in 1.5 to 2% of all pregnancies and ruptured ectopic pregnancies account for 6% of all maternal deaths [cite num=”1″]. Point-of-care ultrasound (either trans-abdominal or trans-vaginal) has become the standard of …
Clinical Question: How effective is intra-articular lidocaine for shoulder reduction?
The use of intra-articular lidocaine for shoulder dislocation is a reasonable and evidence-based approach to facilitate shoulder reduction. This Clinical Question outlines the evidence to support its use and links to an excellent point-of-care video for outlining the procedure.
Medical Concept: Optic Neuritis
Optic neuritis is inflammation of the optic nerve. It typically presents with loss of vision, dyschromatopsia (color vision impairment) and ocular pain.
Boring Question: Fecal Leukocytes. Eh?
What are Fecal Leukocytes? Exactly what they sound like – white blood cells in liquefied poop. They can represent an inflammatory cause of diarrhea (acutely from infection or from an initial presentation of inflammatory bowel disease).