Author Affiliation J. Toscano, MD San Ramon Regional Medical Center, San Ramon, CA To the Editor: When I first saw the title of the study by Julie Gorchynski et al in the February 2007 issue of the Western Journal of Emergency Medicine, I thought, “Eureka!” We surely have to reason our way through a great […]
A 22-year-old intoxicated male presented to the emergency department after jumping from a second-story window, landing on his right foot. He was able to ambulate with a great deal of pain across the dorsum of his foot. Physical examination revealed significant tenderness to palpation over the second metatarsal with minimal edema.
A 40-year-old female presented to the emergency department with a one-week history of URI symptoms and a one-day history of more severe throat pain and swelling.
A 62-year-old Asian male with a past medical history significant for diabetes mellitus, hypertension, and prior surgical correction of a retinal detachment of the right eye presented to the emergency department (ED) for further evaluation of an abnormal examination by his optometrist.
A 42-year-old patient presented with chest pain and shortness of breath. The pain was atypical for cardiac disease, started suddenly, occurred at rest and was non-radiating.
Author Affiliation Chris Feier, MD Department of Emergency Medicine, Keck School of Medicine University of Southern California INTRODUCTION “Clinical Emergency Medicine (EM) Algorithms” was born out of my frustration with the educational process in medicine. Throughout medical school, professors teach us by a disease-based system. We read textbooks and learn about Takayasu’s Arteritis andDiphyllobrohtium […]
A 19-year-old female with Systemic Lupus Erythematosus (SLE) presented with ischemia of her left hand following trauma. Medical therapy was initiated but failed to improve her symptoms, and revision amputation was ultimately performed. The patient’s final diagnosis was digital ischemia due to secondary Raynaud’s Phenomenon (RP). The authors discuss diagnosis, complications, and treatment of this relatively uncommon disorder. The authors report this case in order to discuss how secondary RP can be complicated by ischemia and the multidisciplinary approach that needs to take place to prevent the latter from occurring.
Author Affiliation Joseph Brownfield, MD Department of Emergency Medicine, Keck/USC School of Medicine, Los Angeles, CA Mel Herbert, MD Department of Emergency Medicine, Keck/USC School of Medicine, Los Angeles, CA INTRODUCTION Reading EKGs is an integral skill in Emergency Medicine, especially given the fact that determining the presence and amount of ST segment elevation […]
Author Affiliation Gus M. Garmel, MD Stanford University School of Medicine/Kaiser Permanente, Santa Clara INTRODUCTION Patients presenting to the emergency department (ED) with electrocardiograms (ECGs) indicating wide complex tachycardias (WCTs) are difficult to manage. Furthermore, these ECGs are often challenging to interpret.1,2 Patients typically have ongoing chest discomfort, with or without symptoms of dyspnea, lightheadedness, […]
Author Affiliation Robert W. Derlet, MD University of California, Davis School of Medicine, Department of Emergency Medicine John R. Richards, MD University of California, Davis School of Medicine, Department of Emergency Medicine INTRODUCTION Over the past decade, emergency department (ED) crowding has occurred and progressed. It has become a major topic of discussion at […]
Author Affiliation Sanjay Arora, MD Department of Emergency Medicine, Keck/USC School of Medicine, Los Angeles, CA INTRODUCTION Emergency physicians must be comfortable and confident in providing safe and effective procedural sedation and analgesia (PSA). Goals of PSA include providing an adequate level of sedation while minimizing pain and anxiety, maximizing amnesia, minimizing the potential […]
Prediction models using multiple logistic regression are appearing with increasing frequency in the medical literature. Problems associated with these models include the complexity of computations when applied in their pure form, and lack of availability at the bedside. Personal digital assistant (PDA) hand-held devices equipped with spreadsheet software offer the clinician a readily available and easily applied means of applying predictive models at the bedside. The purposes of this article are to briefly review regression as a means of creating predictive models and to describe a method of choosing and adapting logistic regression models to emergency department (ED) clinical practice.
Lumbar Puncture (LP) is an invasive procedure frequently used to diagnose meningitis among the pediatric population. Neonates and infants have not routinely received local anesthesia prior to LP.
