Tamingthesru
Crash and Burn: The Approach to the MVC Patient
Certain pathology gets a lot of attention in medical school. Stroke? Sure! Tests love asking about which vessel is blocked based on clues from the physical exam. And rightly so; a fund of medical knowledge is certainly valuable when it comes to identifying pathology such as this. However, when faced with a problem like blunt trauma, i.e. the “MVC”, one may find that there are also many practical and logistical factors that require bedside experience, ranging from marshaling of resources to reconciling patient presentation with reported mechanism of injury...
Take My Breath Away! Evaluation of Shortness of Breath in the ED
There are many chief complaints in the emergency department that can be less than satisfying (*cough* abdominal pain *cough*). Sometimes such patients end up having a completely benign examination, no significant risk factors found on history, and an encounter that leaves you shrugging your shoulders and telling the patient “bellies will do that sometimes, we don’t always find out why.”
Of course, this is all anecdotal, but the chief complaint on this month’s episode seems to have a more consistent presence of pathology with a wide range of severity. With such heterogeneous pathophysiology we turn to the mind of Dr. Stewart Wright to discuss the initial approach to the patient with shortness of breath (SOB)...
Dazed and Confused: The Approach to Altered Mental Status in the ED
We will all have the experience of taking care of a patient in the emergency department who is acting…different than they normally do. Sometimes, the change can be subtle, maybe a family member will be the first to notice and bring the patient to be evaluated. Sometimes the patient makes the change abundantly clear. In either case it is essential to identify the underlying cause and treat any emergent conditions precipitating this dysfunction of the brain. This month we hear from Dr. Erin McDonough on her approach to the patient with altered mental status (AMS).