Thursday, June 28, 2018

Legal Implications of Responding to In-flight Medical Emergencies

Image Credit: Pixabay
This post was peer reviewed.
Click to learn more.

Author: Ali Bacharouch, MSIII
University of Michigan
AAEM/RSA Education Committee

Imagine boarding your flight to Fort Lauderdale after a hectic few months at the hospital. As the plane takes off you begin to think about how relaxing your trip is going to be. As you are trying to sleep, you hear some sounds coming from the back of the plane that give you flashbacks of the emergency department. You then hear an announcement the intercom system: “A fellow passenger needs medical attention; if you are a medical professional please identify yourself to a cabin crew member.” You quickly spring into action and attend to an elderly woman who reports new-onset lightheadedness. After ruling out life threatening conditions, you provide reassurance and head back to your seat as the woman expresses her gratitude.

Sunday, June 24, 2018

Update on Direct Oral Anticoagulants in the Emergency Department

Authors: Megan Donohue MD, MPH, Erica Bates MD, Robert Brown MD, Christine Carter MD, Hannah Goldberg MD.
Editors: Kami M. Hu MD FAAEM, Kelly Maurelus, MD FAAEM
Originally Published: Common Sense May/June 2018

Questions: What new information do we have regarding direct oral anticoagulants (DOACs), specifically:
  1. What is the most recent safety data?
  2. Do our standard coagulation assays provide an accurate measure of anticoagulant activity?
  3. Where do we stand with reversal agents?

Thursday, June 21, 2018

The Unfortunate Case of the Costa Rican Colles’ Fracture: An Up-Close case study of Costa Rica’s Emergency Department

Image Credit: Pixabay
Author: Kayla King
Originally published: Common Sense May/June 2018

Picture this: you’re on a study abroad in beautiful, picturesque Costa Rica, in between your first and second year of medical school, learning about their health care system and practicing medical Spanish. You’re traveling to volcanoes, beaches, national parks, and national sloth reserves, taking pictures for every social media account possible, with six classmates. Seems glorious, right? Now, imagine that you’re doing all this, except you have a bright blue cast on your dominant wrist.

… What?

Sunday, June 17, 2018

In Vitro Fertilization: Complications and Special Considerations in the Emergency Department

This post was peer reviewed.
Click to learn more.
Authors: Alexandria Gregory, MS-4
Medical Student Saint Louis University School of Medicine
AAEM/RSA Social Media Committee

Eric Goedecke, DO
Milford Regional Medical Center

A 41-year-old female presented to the emergency department (ED) with a several-day history of abdominal pain, nausea, vomiting, and lightheadedness. She reported that she was currently five weeks pregnant after having in vitro fertilization (IVF) in which two embryos were implanted. She had a history of one prior miscarriage, but no other pregnancies. She reported that she was followed by an obstetrician (OB) and had had two normal ultrasounds during this pregnancy. The patient had no vaginal bleeding, vaginal discharge, fever, or chills.

On exam, the patient’s initial vital signs were as follows: temperature 97.3° F, pulse 60 bpm, blood pressure 58/32 mmHg, respiratory rate 19, and oxygen saturation 98% on room air. The patient was in severe distress. Abdomen was diffusely tender and distended with guarding. Skin was pale and clammy.