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High sensitivity cardiac troponins for ED chest pain evaluation (2022 ACC pathway)

ALiEM

Encourage your ED to set up an algorithm that you can follow based on your laboratory’s assay. Low-risk patients do not routinely require stress testing in the ED. You (or someone in your department) needs to know which assay your ED has, and use the appropriate values for that assay. Otherwise, apply a simplified approach.

E-9-1-1 276
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SAEM Clinical Images Series: Spontaneous Eye Luxation

ALiEM

Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. This happened once 10 years ago, requiring reduction in the ED. A 55-year-old female presented with the complaint of my right eye popped out. Available at: [link] (Accessed: 04 January 2024).

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Summer Penile Syndrome

Pediatric EM Morsels

McGraw Hill; 2021. J Emerg Med. 2014 Jan;46(1):e21-2. doi: 10.1016/j.jemermed.2013.08.081. 2013.08.081. Epub 2013 Nov 5. PMID: 24199728. Shah A, Sobolewski B, Mittiga MR. Summer Penile Syndrome. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e. Accessed September 06, 2023.

EMS 278
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TXA (Tranexamic Acid) in Pediatrics 

Pediatric EM Morsels

TXA has been mentioned previously on PEM Morsels in the following contexts: Post Tonsillectomy Hemorrhage , Hemophilia in the ED , Von Willebrand Disease , Epistaxis in Children , Hereditary Angioedema , Hemoptysis in Children , Hyphema , and even in Neonatal Subgaleal Hemorrhage. of IV form TXA [O’Neill 2020] Inexpensive !

E-9-1-1 231
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BPAP vs AVAPS for Hypercapnic Respiratory Failure in the ED

REBEL EM

Balkan Med J 2021. The AVAPS mode is as effective and safe as BPAP S/T in treating patients with hypercapnic respiratory failure in the ED.” Clinical Take Home Point: I n patients presenting to the ED with hypercapnic respiratory failure, AVAPS did lead to a faster improvement in pH and PaCO2 levels compared to BPAP S/T.

ED 129
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Superior Mesenteric Artery Syndrome (SMA Syndrome) in Children

Pediatric EM Morsels

Let’s take a take a minute to review Superior Mesenteric Artery Syndrome presenting in the ED so we will be prepared when you see it! England, 2021) The third portion of the duodenum courses between the SMA and the aorta, which can lead to external compression of the duodenum. England, 2021). Record, 2015).

E-9-1-1 246
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Pseudoparalysis of Parrot

Pediatric EM Morsels

Now, let’s discuss another complication of “The Great Mimicker” which may throw us for a loop in the ED – Pseudoparalysis of Parrot : Pseudoparalysis of Parrot – Basics First described by Jules Marie Parrot in 1871. In 2021 there were almost 177,000 cases of syphilis. July 22, 2021. The Journal of Pediatrics.

Plasma 271