Thursday, May 25, 2017

Interstitial versus Cornual Pregnancies: There is a Difference

Image Credit: Pixabay
Author: Megan Litzau, MD
Indiana University
Originally Published: Modern Resident April/May 2016

Commonly the terms interstitial and cornual pregnancies are used interchangeably. However, these are two distinct entities, and are managed differently.[1] An interstitial pregnancy occurs when there is implantation in the proximal intramural portion of the fallopian tube. A cornual pregnancy is when there is implantation in the lateral portion of the uterus.

Thursday, May 18, 2017

Case Report: Hypopharyngeal Burns Secondary to Hot Potato Ingestion


Image Credit: Pixabay
This post was peer reviewed.
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Author: Alexandria Gregory, MS-2
Saint Louis University School of Medicine AAEM/RSA Social Media Committee

Eric Goedecke, DO
Milford Regional Medical Center

Overview

A 59-year-old male presented to the emergency department (ED) with a food bolus sensation several hours after eating hot potatoes for breakfast. Since then, he had been able to tolerate coffee, scrambled eggs and handle his secretions without difficulty. He was feeling well otherwise and denied any recent illness.

On exam, the patient was well-appearing and in no respiratory distress. There was no wheezing or stridor. Oropharyngeal exam showed no edema, lesions, burns, or visible foreign body. The remainder of the physical exam was unremarkable.

Sunday, May 14, 2017

Button Batteries

Image Credit: Flickr
Author: Phillip Fry, MSIV
Midwestern University - Arizona College of Osteopathic Medicine
Originally Published: Modern Resident February/March 2017

Patients presenting to the emergency department after ingesting a button or cylindrical battery typically warrant prompt foreign body removal. The majority of battery ingestion cases involves button batteries and occurs in children younger than six years of age.[1] However, there is also a growing number of ingestions in the elderly with hearing aid batteries being mistaken for pills.

Thursday, May 11, 2017

Eyelid Lacerations

Image Source: Flickr
Author: Kaitlin Fries, DO
Doctors Hospital
Originally Published: Modern Resident February/March 2016

Eyelids are often one of the more complex locations for providers to perform laceration repairs. The eye has many important neighboring structures that can often be damaged by even minor trauma to the eye. As with any wound, it is important to start by doing a thorough exam of the tissue involved, being sure to assess for the possibility of a retained foreign body. Once the area has been evaluated it is time to ensure that a few critical nearby anatomical structures are still intact.

Sunday, May 7, 2017

Chilaiditi’s Syndrome

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Image Credit: Wikipedia








Author: Megan Litzau, MD
Indiana University Emergency Medicine Residency

A previously healthy 29-year-old male arrived with right upper quadrant pain for approximately six hours prior to arrival. On examination, the patient appeared uncomfortable. Vital signs were remarkable for mild tachycardia with an afebrile patient. Labs were obtained including a complete metabolic panel, complete blood count, lipase and urinary analysis. All of the lab values returned within normal limits. Given the patient’s persistent abdominal discomfort, computed tomography (CT) imaging of the abdomen was also obtained. On CT imaging, a segment of his transverse colon was located in an abnormal position between his liver and his diaphragm, which was in the correct location for the patient’s discomfort.

Thursday, May 4, 2017

Did You Know? Broselow Pediatric Emergency Tape

Image Credit: Wikimedia Commons
Author: Jenna Erickson, MD
Phoenix Children's Hospital/Maricopa Medical Center
Originally Published: Modern Resident August/September 2015

In a pediatric trauma, one of the initial treatment steps is determination of a child’s “color.” This is referencing the Broselow Pediatric Emergency Tape, an old but widely accepted method of estimating a child’s weight based on length. Pediatric drug dosing is based on weight, therefore a fast, efficient way to calculate dosing is essential to reduce medical error and optimize patient outcomes. The Broselow Tape is a color-coded tape measurer consisting of nine color zones that group together pediatric medication doses and equipment sizes. When a child first arrives in a trauma bay he is measured with the tape from crown to heel. The color that is reached by the child’s heel indicates a weight estimate; this color is then used for a quick reference sheet of pre-calculated medication doses, voltages and equipment sizes. Resuscitation carts with color-coded drawers further simplify the process of selecting the correct supplies for pediatric patients, thus expediting treatment and minimizing error.