Ultrasound of the Month: Can you use Pocus for pneumonia?
Down East Emergency Medicine
by Weeden Bauman, MD
1y ago
THE CASE A 13-year-old boy is seen in the Emergency Department (ED) for a cough.  He reports a viral illness starting two weeks ago, and four days ago, he was seen in the ED because his symptoms were worsening.  At that time, he got a chest X-ray showing a right lower lobe consolidation. He was diagnosed with pneumonia and started on high-dose amoxicillin and azithromycin.  However, his symptoms failed to improve, and he now returns with a worsening cough and shortness of breath despite antibiotics.  His vitals are notable for a fever of 102.4F, HR 131, BP 112/78, RR 24,and ..read more
Visit website
Bread and Butter Abdominal Ailments for Medical Students in the ED
Down East Emergency Medicine
by Hallie Bates MSIV
2y ago
     Abdominal pain is the most common chief complaint for adult patients in the ED. [1]  It’s one of the presenting symptoms that can run the gamut between largely benign to imminently lethal, making it imperative for medical students to be able to triage and assess it appropriately.  Key Concepts Quickly rule out life-threatening emergencies that require immediate resuscitation. Think aortic aneurysm dissection, bowel perforation, STEMI (especially in elderly female patients!), ruptured ectopic pregnancy, etc.  These are the “can’t miss” diagnoses! Some good ..read more
Visit website
Ultrasound of the Month: A Case of Unilateral Knee Swelling
Down East Emergency Medicine
by Joshua Rehberg
2y ago
THE CASE A 44 year old male with a history of right ACL repair 1 year ago presents with right knee pain and swelling after a fall. He was helping his neighbor fix their snowblower when he slipped and fell backwards. He denies hitting his knee on the ground but felt a pop in his right knee during the fall. He reports feeling as though his patella was “out of place” but then it popped back in and his pain improved somewhat. He now has worsening swelling of his leg, an inability to extend at his knee and an inability to weight-bear. He has no numbness or tingling radiating down his leg. No ankle ..read more
Visit website
Pathways to Emergency Medicine: What to Know Early in the Career Exploration Process
Down East Emergency Medicine
by Hallie Bates MSIV
2y ago
Emergency medicine (EM) was first recognized as a specialty by the American Medical Association (AMA) in 1972.  Since that time, EM residencies have grown and evolved to provide academic support and training for graduating medical students interested in pursuing a career in the field.  Since its early days of small and scattered residency programs, EM has burgeoned to nearly 3,000 residency positions according to the 2021 Report on Residents published by the Association of American Medical Colleges (AAMC).  As EM becomes an increasingly popular career choice among students, resi ..read more
Visit website
Ultrasound of the Month - Not all veggies are good for your health
Down East Emergency Medicine
by Joshua Rehberg, MD Ultrasound Fellow
2y ago
Case presentation A 37-year-old female with a history of mild intermittent asthma, hepatitis C, and opioid abuse disorder (in remission for the past year being maintained on buprenorphine) presents to the emergency department after being called due to positive blood cultures. She was seen at urgent care the day prior for a worsening progressive cough, shortness of breath, and pleuritic right anterolateral chest pain. Review of her records show she was diagnosed with multifocal pneumonia in July, 2021 and treated with dual therapy of Augmentin and Azithromycin. Subsequently, she was diagnosed w ..read more
Visit website
Emergency Department - Initiated Buprenorphine for Opioid Use Disorder
Down East Emergency Medicine
by Tania D. Strout, PhD, RN, MS
2y ago
  Background Recent data from the National Center for Health Statistics reveal that in the 12-month period ending in April 2021, more than 100,000 Americans died of an overdose, a staggering increase of nearly 30% the prior year. While the ongoing COVID-19 pandemic has contributed to overdose deaths and taxed constrained Emergency Department (ED) resources, it has also clarified the important role that emergency physicians have in expanding access to life-saving medications to treat opioid use disorder. In this journal club, we review the evidence on ED-initiated buprenorphine, including ..read more
Visit website
Ultrasound of the Month - Is your probe marker switched?
Down East Emergency Medicine
by Joshua Rehberg, MD Ultrasound Fellow
2y ago
CASE PRESENTATION A 73 y.o. male with history of diastolic heart failure, type II DM, HTN, and peripheral vascular disease presented to the emergency department via EMS for evaluation of abnormal vital signs. He was found at his living facility to have an oxygen saturations of 57% on room air (RA). EMS found his pulse oximetry to be 80% on RA and he was placed on 5L oxygen via nasal cannula. Upon arrival to the emergency department he remained hypoxic, with an SpO2 of 79% on room air. He improved to the mid 90s with 4L nasal cannula. He states that he has been having some w ..read more
Visit website
Journal Club - Physician Depression and Suicide
Down East Emergency Medicine
by Casey MacVane, MD, MPH
2y ago
  Background Suicide is disturbingly prevalent among patients we care for in the Emergency Department.  It is unfortunately also common among physicians. Most estimates suggest that approximately 400 physicians die by suicide annually.  Physicians also have a higher rate of suicide than the general population. Male physicians have a 40% increased risk of suicide compared to their age-matched peers and female physicians have a 130% increased risk.  We chose this topic for Journal Club with the goals to raise awareness around these shocking statistics, discuss etiologies behi ..read more
Visit website
The Case to Replace Alteplase
Down East Emergency Medicine
by Jane Morris, MD
2y ago
This lecture was presented at the 2021 Maine Medical Center Winter Symposium. For more information on the symposium click here.  Pharmacological differences between alteplase and tenecteplase: Alteplase (tPA) is a recombinant version of naturally occurring enzyme called tissue plasminogen activator. Tenecteplase (TNK) is a bioengineered variant of tPA to make it a better lytic by increasing its specificity to fibrin and more resistant to degradation by endogenous enzymes. Half-life: TNK: Initial: 20–24 minutes; Terminal: 90–130 minutes tPA: Initial: 5 minutes; Terminal: 72 minut ..read more
Visit website
Journal Club - Pain management of Renal Colic
Down East Emergency Medicine
by Timothy Fallon, MD
2y ago
  Background Renal colic is a commonly encountered diagnosis in the emergency department that is known to cause significant pain. In clinical practice, the initial goal is prompt pain management while simultaneously working to confirm the suspected diagnosis. Because of the severity and acuity of the pain associated with renal colic, opioid pain management has often been used. Given the overall goal of reducing the use of opioid pain medications, emergency physicians have been working to identify alternative pain management strategies with agents such ketorolac and lidocaine. In this jou ..read more
Visit website

Follow Down East Emergency Medicine on FeedSpot

Continue with Google
Continue with Apple
OR