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Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

ACEP Now

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. Managing post-tonsillectomy hemorrhage in the ED can be challenging, especially in rural or resource-limited settings. Hemoptysis ED approach and management. Its going to take time to get her to a tertiary center.

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Episode 35: When to operate in trauma with Dennis Kim

Critical Care Scenarios

Takeaway lessons * Trauma patients who are hypotensive or otherwise unstable should be assumed to be bleeding, bleeding, bleeding until proven otherwise, and should have a very low threshold to proceed directly to the operating room for exploration.* pneumatically), then definitively addressed by Orthopedics at their convenience.

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SGEM#205: Twist & Shout – Testicular Torsion

The Skeptics' Guide to EM

In her spare time, Melissa also enjoys being the fellowship director to an amazing group of PEM trainees. Case: Brian is a 14-year-old male who presents to the emergency department (ED) complaining of acute onset testicular pain. He has vomited twice, but there is no history of any fever or trauma. Reference: Frohlich LC, et al.

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EM@3AM: Retroperitoneal Hematoma

EMDocs

A 70-year-old female with a past medical history of hypertension, coronary artery disease s/p 2x drug eluting stent placement one month ago, atrial fibrillation on apixaban presents to the ED with weakness and lightheadedness. F, RR 16, SpO2 97% on room air. Vital signs include BP 90/48, HR 122, T 98.3

EMS 90
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EZ-IO® Emergency Burr Hole for Epidural Hematoma

Handtevy

The standard care in North America for post-traumatic EDH involves decompressive craniotomy or trepanation via a burr hole, typically performed in an operating room by neurosurgery teams. Initially refusing emergency medical services, she was brought to the ED via a private vehicle. What are the key takeaways? (1)

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The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults

REBEL EM

This study chose a relevant topic to analyze that could influence acute management in the ED and has a fairly larger sample size of patients to do so. The impact of push-dose phenylephrine use on subsequent preload expansion in the ED setting. 2015;10(3):e0119331. PMID: 25789927 Schwartz MB, et al. Am J Emerg Med.

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Case Report: EMS Says Flail Chest, But Is It?

ACEP Now

A 58-year-old male with a history of alcohol abuse presented to the emergency department (ED) as a category 2 trauma for a fall with a reported flail chest. On hospital day 2, he was taken to the operating room for surgical rib fixation. Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). Click to enlarge.)

EMS 52