This weeks case highlights the challenges of ED management of DVT and DVT work-up. We discussed risks and benefits of pursuing CT imaging. We also discussed the challenges of what to do with limited options for IV access. CT imaging was deferred due to lack of reliable IV access. X-ray of the left upper extremity […]
Hot Seat #265 Denouement
This weeks case highlights the challenges of ED management of rashes. We discussed the true dermatologic emergencies and their typical presenting symptoms. We also discussed the differences between DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) vs. DILI (drug-induced liver injury). The patient was admitted for observation and further evaluation for concern of a drug-induced […]
Hot Seat #266: Clot Twist
Case by Jamal Alanni, CNH PEM Fellow Chief Complaint: Right arm pain and swelling, chest pain, dyspnea, and headache History: A 17-year-old male with a history of migraines presented with 2 weeks of progressive right upper extremity pain and swelling, associated with headache, chest pain, and dyspnea. Two weeks earlier, he had been seen at […]
Hot Seat #265: Rash Decisions
Case by Maria Elena Arrate, CNH PEM Fellow A 12-year-old girl with hx of a thyroglossal duct cyst status post excision 1.5 months ago is presenting with 2 days of fever, headache, nausea, and a new diffuse rash. The excision was complicated by neck swelling at the surgical site despite treatment with Augmentin and subsequently […]
Hot Seat #264: Acute or Chronic?
Case by Brittany Fitzpatrick, CNH PEM Fellow 8yo F w/ PMH of chronic active EBV (CAEBV) complicated by HLH, s/p BMT complicated by EBV-related relapse and GVHD, now presenting with acute on chronic abdominal pain. Mom says patient has had waxing and waning abdominal pain for years since BMT, but it has acutely worsened this week, currently rated as 8/10 in severity. Reported a fever (100.8) 6 […]