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Case Report: The Hangover and the Lateral Canthotomy

In Case Series, Medical Concepts by Maheshver ShunmugamLeave a Comment

Alan Garner is a 38-year-old single, unemployed, Caucasian male, with a medical history of ADHD who has voluntarily arrived at the ED accompanied by friends Stu and Phil after being punched in the face while trespassing. Despite having a poor recollection of the night’s events, Alan and friends are certain that he received a sucker punch by none other than Mike Tyson, the former undisputed world heavyweight boxing champion. Phil informs you that, …

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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: HOUSE as a discharge guide for marginalized patients that incorporates the social determinants of health

In Tiny Tips by Nicole MathiesLeave a Comment

Emergency Departments are often the primary source of healthcare for marginalized patients with substance use disorders and precarious housing​1​. As such, we have unique opportunities to intervene and initiate change. While many screening tools exist to identify substance use disorders, the novel H.O.U.S.E. mnemonic is the first to cover high yield items to be discussed with patients prior to discharge​2​. It can be used as an easy to remember tool to ensure that …

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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, …