Pain Pearls – Nitrous Oxide

As part of our EM training at St. Joseph’s University Medical Center we are lucky to receive additional training in alternative methods of analgesic delivery in the ED. Some of these alternatives include ultrasound guided regional nerve blocks,  nonnarcotic infusions and injections, nitrous oxide, and the list goes on. Today’s post is a review of our Nitrous program developed by Dr. Alexis LaPietra.

Euglycemic DKA

Hi all. I wanted to bring to your attention a great case. The case was a young woman with relative euglycemic diabetic ketoacidosis. This diagnosis used to be quite rare and associated with pregnancy or very poor PO intake. However, with the use of SGLT2 inhibitors (which this young woman was taking) the incidence is increasing. The diagnosis highlights some very important factors about the treatment of DKA.

Case of the week COW #10

CC: Nausea and vomiting and “ I think my sugar is low” HPI: 36-year-old Female with PMH of Diabetes presents to the Emergency Department complaining of multiple episodes of non-bloody, non-bilious vomiting for the past 5 days. Associated symptoms include […]

Case of the Week COW #9

CC: “Post Surgical Pain” ; Abdominal pain HPI: 8 year old Male with PMH of Sickle Cell Disease (HbSC), Post-opt Day 10 for laparoscopic splenectomy for recurrent sequestration crises presents to the Emergency Department (ED) complaining of abdominal pain x […]

Case of the Week COW #8

CC: Altered Mental Status HPI: 50 -year-old Male with PMH of HIV, CVA and Meningitis presents to the Emergency Department (ED) for altered mental status. As per the patient’s girlfriend at bedside, the patient woke up confused and was not […]

Case of the Week COW #7

CC: Numbness and palpitations HPI: 21-year-old Female presents to the Emergency Department (ED) complaining of palpitations and left arm weakness with perioral numbness, which began just prior to arrival. The patient states the episode lasted 30 minutes before completely resolving […]

ACEP Now Review on LVADs

Check out this excellent review on managing patients with LVADs from this month’s ACEP Now publication which was written by our own Dr. Yenisleidy Paez Perez, DO PGY-3 and one of our newly graduated residents, Dr. Terrance McGovern, DO.

Breaking Bad News

One of the hardest roles of the emergency physician is giving bad news to a patient or their family members. We review the challenges of this difficult task and introduce a method that can be used to effectively communicate to our patients and/or their families.

Case of the week COW #6

CC: Vomiting for 2 days HPI: 32 yo female with PMH of Romano Ward Syndrome s/p AICD, previous cardiac arrest, Atrial Fibrillation s/p Ablation, renal artery thrombosis on Coumadin and deafness presents to the Emegency Department (ED) via ALS after […]