June 1, 2017
A 55 year old man presented with intermittent chest pain for 2 weeks. His pain is currently a 7/10 and here is the initial ECG: Troponins remained negative. A second ECG was done 12 hours after the first:Nothing overtly impressive – some subtle ST elevation
May 29, 2017
Prescription drug overdose has surpassed motor vehicle accidents as the number one cause of unintentional injury-related death. For the suspected opiate overdose who is unresponsive, there are few options outside of endotracheal intubation and supportive care. Naloxone (Narcan) is generally regarded as safe and with
May 29, 2017
An infant presented to the ER with vomiting. Mother noted the child had less energy than usual and vomited twice in the last 24 hours; twice more while in the ED. He was afebrile, and per the ED note, this is what was free-texted under the
April 9, 2017
A 4 year old boy presents after falling onto his elbow. Here’s the AP view: It’s seldom this obvious, but the child has a supracondylar humeral fracture. Diagnosis usually requires looking at the lateral film for the presence of a fat pad. Fat pads represent joint
April 9, 2017
A recent verdict in a New Jersey medical malpractice case has me shaking my head in bewilderment. Here’s the setup: A 2 month old infant was brought to the ER. Mother reported that the child was unable to straighten his leg and would cry when
March 30, 2017
A 16 year old boy was playing basketball. He planted, twisted, and fell to the ground in agony. Here’s his x-ray: The finding is straightforward: fractured right femoral shaft. But if you look closely, you can notice that this is a ‘pathologic fracture’ with the
March 30, 2017
A 35 year old man is fighting a ninja when he gets open-fist slammed in the chest. His vital signs and physical exam are both unremarkable. What do you do? A. Order an EKG B. Check cardiac enzymes C. Observe for 4-6 hours D. All of the
March 15, 2017
A male in his 60s presents by EMS with sudden onset of a headache while at work. His initial blood pressure is 210/90mmHg. On exam, he is slow to answer questions and follow commands. He cannot lift either leg off the bed but his exam
