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SAEM Clinical Images Series: Pediatric Neck Mass

ALiEM

A 5-year-old female presented to the emergency department (ED) with a one-year history of gradually increasing anterior neck swelling. She was discharged from the ED on levothyroxine 25 mcg daily with endocrinology outpatient follow-up. 2014 Dec;24(12):1670-751. The patient had no significant past medical history. 2014.0028.

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Beyond Ketamine: When to use Facilitated Intubation in the ED

EMDocs

However, RSI has never been shown to reduce the risk of aspiration in the ED (13) or during emergent OR cases (14). While RSI should remain the gold standard in the vast majority of patients in the ED, FI presents an additional technique to mitigate anatomic or physiologic risk. To date, ketamine has been the agent of choice (12).

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Occlusion myocardial infarction is a clinical diagnosis

Dr. Smith's ECG Blog

The neighbor recorded a systolic blood pressure again above 200 mm Hg and advised her to come to the ED to address her symptoms. Both the outdated 2014 AHA/ACC guidelines and the updated 2023 ESC guidelines recommend immediate invasive management of patients with uncontrolled chest pain. She contacted her neighbor, a nurse, for help.

E-9-1-1 121
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Sickle Cell Disease Module

Don't Forget the Bubbles

Haematology specialist clinics are key to manage the chronic side of the disease, while ED doctors should be able to act rapidly on the common acute emergencies. with thanks A 15-month-old Kenyan boy presents to ED with right hand swelling. A 10-year-old boy with known SCA presents to ED due to severe pain in the legs.

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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

Smith: If this is ACS (a big if), t his is just the time when one should NOT use "upstream" dual anti-platelet therapy ("upstream" means in the ED before angiography). History sounds concerning for ACS (could be critical stenosis, triple vessel), but differential also includes dissection, GI bleed, etc. Anything more on history?

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

An 8-year old male with a history of sickle cell anemia presents to the ED for evaluation of fever for 2 days and “feeling like I can’t get a full breath”. 768: Epidemiology of Hospital Based ED Visits due to Sickle Cell Crisis and Acute Chest Syndrome in Kids. Chinawa JM, Ubesie AC, Chukwu BF, Ikefuna AN, Emodi IJ. C or 100.4

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Acute OMI or "Benign" Early Repolarization?

Dr. Smith's ECG Blog

Cardiology consult note written around that time documents that "Pain improved with NTG, morphine in ED but still present." The note also says "slight lateral ST elevations noted, likely early repolarization since unchanged compared to 2014." We therefore need to assume and rule "out" ACS — more than having to rule it "in".

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