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DVT

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General Approach to Patients. SUNY Buffalo Emergency Medicine. Vaginal Bleeding in the non-pregnant patient. Doppler ultrasound testing is moderately expensive because it relies on sophisticated equipment and a specially trained technician. Doppler is not available 24/7 in many hospitals. D-dimer testing is less expensive and generally available 24/7. D-dimer has many false positives and some, though fewer, false negatives. D-dimer testing should not. Who should be tested for DVT? Redness/swelling and te...

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General

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General Approach to Patients. SUNY Buffalo Emergency Medicine. Vaginal Bleeding in the non-pregnant patient. General Approach to the ED Patient. At the risk of stating the completely obvious, this essay assumes that patient doesn’t need any immediate intervention to stabilize them. When you walk in the room and start a history you learn that your generally healthy patients has not had any injury, since there was not you have immediately ruled out a major fracture of dislocation. Not all emergency physici...

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ChestPain

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General Approach to Patients. SUNY Buffalo Emergency Medicine. Vaginal Bleeding in the non-pregnant patient. This essay concerns the evaluation of patients who present with “just” chest pain. That is to say that chest pain is truly the primary complaint. Acute MI/Acute Coronary Syndromes (ACS). Thoracic Aortic Disasters (primarily dissection). Chest pain with cough and sputum strongly suggests an infectious respiratory illness. Chest pain and a dermatomal rash are very suggestive with thoracic zoster.

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OD

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General Approach to Patients. SUNY Buffalo Emergency Medicine. Vaginal Bleeding in the non-pregnant patient. Is this an OD? Nursing staff, pre-hospital personnel, and the ED MD sometimes misidentify patients with ALC as having an OD without much evidence to support it. The best way to avoid this is simply to ask: why did they come to this conclusion? If the answer doesn’t make sense, consider other causes of ALC (see separate essay). A benzodiazepine OD would be expected to be drowsy, but not tachycardic.

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Students

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General Approach to Patients. SUNY Buffalo Emergency Medicine. Vaginal Bleeding in the non-pregnant patient. EM the Good, the Bad, and the Ugly. This essay is aimed at medical students contemplating a career in Emergency Medicine. If you are an EM resident you may also find it useful in terms of helping you identify “red flags” when you go job hunting. Any resident in EM or student interested in EM should read. The Rape of Emergency Medicine. A job or a career. And let me know what you think of the site.

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AMS

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General Approach to Patients. SUNY Buffalo Emergency Medicine. Vaginal Bleeding in the non-pregnant patient. Altered Mental Status/Altered Level of Consciousness. One study of 317 patients published in Am. J. of Emerg. Med found the following were the causes of AMS in an ED population: Neurologic 28%, Toxic 21%, Traumatic 14%, Psychiatric 14%, Infectious 10%, Endocrine/Metabolic 5%, Pulmonary 3%, Oncologic 3%, CV 1%, Renal 1%, GI 1%. The high yield causes of ALC include:. Think of the simple things first.

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UGIB

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General Approach to Patients. SUNY Buffalo Emergency Medicine. Vaginal Bleeding in the non-pregnant patient. The purpose of this essay is to help you learn about the causes, workup, treatment and disposition of patients who present to the ED with upper GI bleeding (UGIB). So, a history of vomiting blood and bloody stools = UGIB. This is quite reliable. How about coffee ground emesis (CGE)? Take some left over blood drawn on a patient. Mix with clear gastric juice from a patient with an NGT. One thing to ...

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headache

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General Approach to Patients. SUNY Buffalo Emergency Medicine. Vaginal Bleeding in the non-pregnant patient. The goal of this lecture is to help you learn how to efficiently and accurately screen for intracranial catastrophes. We will come to the red flags soon, but first you must make a binary decision. You must answer the question is this a primary headache syndrome or is the headache part of a broader symptom complex? CT/LP for the diagnosis of SAH. Sensitivity decreases with time. R McCormack et al.