21-year-old man brought for ED for impaired mental state, he was extremely agitated and needed 6 staff members to restrain him for IV access and sedation. His venous blood gases showed the following:
PH = 6.9
pCO2 = 24 mmHg
Category Archives: Advanced EM Cases
Imaging Case of the Week 545
The following chest x-ray is from a 42-year-old with asthma exacerbation. What can be noticed? Continue reading
shoulder dystocia sim report
The case:
33 year old primip with shoulder dystocia and subsequent PPH, neonate requiring resuscitation initially by attending pediatrician.
Imaging Case of the Week 544 Answer
The chest x-ray shows an incidental finding Continue reading
Imaging Case of the Week 543 Answer
The elbow x-ray shows Continue reading
Imaging Case of the Week 544
Chest x-ray from an adult female with dry retching. What can be seen? Continue reading
Imaging Case of the Week 543
The elbow x-ray is from an adult patient with pain, swelling & inability to move their elbow after a fall on outstretched hand. What can be seen? Continue reading
Imaging Case of the Week 542 Answer
The chest x-ray shows Continue reading
paper of the week
Effect of a Diagnostic Strategy Using an Elevated and Age-Adjusted D-Dimer Threshold on Thromboembolic Events in Emergency Department Patients With Suspected Pulmonary Embolism
JAMA. 2021;326(21):2141-2149. doi:10.1001/jama.2021.20750
Overview
- Combination of PERC, YEARS and age adjusted DDimer has been reviewed regarding the use of advacnced imaging and detection of PE in comparison to the classical pathway (definition below)
Bottom line
- Inclusion of YEARS criteria in workup of VTE patients can be valuable to reduce chest imaging
- This study is not specific for pregnant patients, further clinical trials will be required
Lab case 399 Interepretation
Question 1:
PH = 7.43 that is with in normal range, more toward alkalotic spectrum
HCO3 = 39.9, that is elevated so we have metabolic alkalosis. Next we need to check the compensation process.