Articles Archives - The Emergency Medical Minute

Articles

Lithium Overdose: The Tale of a Light Metal and its Skinny Therapeutic Index

Lithium Overdose: The tale of a light metal and its skinny therapeutic index Chief Complaint: Lithium Overdose HPI: Patient is a 39-year-old male with a past medical history of schizoaffective disorder, alcohol abuse, and prior suicide attempt by drug overdose who presents today due to another suicide attempt. Patient states that his girlfriend recently passed…

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Seeking Pleasure, Suffering Pain

Seeking Pleasure, Suffering Pain Chief Complaint: Abdominal Pain HPI: 21-year-old male presenting to the emergency department after placing a glass mason jar in his rectum 3 days ago, this was done for self-pleasure and experimentation. States that yesterday he tried having a bowel movement after taking stool softener and MiraLAX, reportedly resulted in a normal…

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A Rare Package Delivery

A Rare Package Delivery Chief Complaint: Can we get a doctor? HPI: 37-year-old female presents to the ED. Triage nurse announces on the overhead paging system for a doctor to an acute room. In the background, a woman screaming is heard. Due to the acuity of the clinical picture, no further history is obtained. Pertinent…

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Coronavirus Testing

Coronavirus Testing Chief Complaint: SOB HPI: 43 year-old male anesthesiologist presents to the ED with increasing shortness of breath, tachycardia and lethargy. Patient reports alternating positive and negative COVID tests since early March, job related exposure, as well as travel to Belize and twice to Summit County (considered a hotspot for COVID) since early March….

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A Typical Case of the Pandemic

a typical case of the pandemic Chief Complaint: Altered Mental Status HPI: 69-year-old male with history of diabetes brought in by his son to the emergency department with altered mental status. Patient is unresponsive and all history is from his son and chart review. Son reports that he had increasing shortness of breath and confusion…

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TCA Overdose

tca OVERDOSE DISCUSSION: Background: Tricyclic antidepressants (TCA) were introduced in the 1950s to treat depression, but are now more commonly used as migraine prophylaxis and in the treatment of fibromyalgia, neuropathic pain, and obsessive-compulsive disorder. The shift away from using TCAs for depression was in large part due to the drug’s narrow therapeutic index, which…

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Just the Flu?

Just the Flu? Chief Complaint: Seizure HPI: Patient is a 13 month old M presenting to the ED via EMS following a tonic clonic seizure that per EMS, began around 9:30 AM and lasted at least 15 minutes. The patient’s family is primarily Spanish-speaking and was unable to give adequate history secondary to the language…

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Completely Disassociated

Completely disassociated Chief Complaint: Syncope HPI: An 82-year-old male with a history of bradycardia, HTN and HLD arrives in the emergency department via EMS with altered mental status, pacer pads in place active pacing going. Patient is primarily Russian-speaking and his wife is assisting with translation. The patient is not able to correctly answer what…

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Superior Vena Cava Syndrome

Superior Vena cava syndrome Chief Complaint: Facial Swelling HPI: Patient presents to the emergency department reporting several days of recurrent facial swelling. She states that when she wakes in the morning, starting 3 days ago, she has significant facial swelling. Yesterday there was some extension of the swelling down to her bilateral upper extremities and…

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Gesundheit!!!

Gesundheit!!! Chief Complaint: Headache HPI: 30-year-old female, G1 P0 5 weeks estimated by LMP, states at approximately 08:15 this morning was getting ready to go to work when she sneezed and immediately developed a severe 8 out of 10 headache. Shortly after, she vomited and had diplopia that lasted for 1 to 2 minutes. Diplopia…

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