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Here you will find information regarding rotation schedules, academic resources, wellness and facts about our program and residents. Check out our bios and photos. Please also visit the Emergency Department's official residency website. This site is intended for Mount Sinai EM residency purposes only, and no information on these pages is intended or should be construed as medical advice. Read more.

Cells and Flare

What is the significance of “cells” and “flare” seen on slit lamp examination?

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Compartment Pressures

Chris Hansen (PGY3) let’s Courtney Cassella (PGY1) practice compartment pressure measurements on him.

Hansen - Compartment Pressure

Cqr Q-tips September

Clinical Quality Review topics for September 2014

  • -After ruling out ectopic, involve OB in patients with 2nd trimester miscarriage (these patient are more likely to need an intervention/procedure), or in unwell patients with 1st trimester miscarriage
  • -Discuss with the patient how they will get the prescription, and what the backup plan is if they can’t get the prescription
  • -Specifically consider vascular lesion with isolated hand or foot neurological complaints, such as a numb hand.
  • -Be mindful when ordering non-routine radiology. Have a low threshold to use free text to communicate with radiologist/radiology tech.
  • -Most head-injured patients with loss of consciousness do not need a head CT. Use a decision rule such as the Canadian CT Head rule.
  • -It can be easy to overlook neutropenia on lab results. As a rule-of-thumb, any patient with ANC < 1500 cells/mm^3 is neutopenic. All of these patients with fever should at minimum be admitted and most should have empiric antibiotics dosed.  Even without fever, all of these patients should be referred for urgent follow-up. Consider admission for patients with severe neutropenia (ANC < 500 cells/mm^3) even without fever.
  • -An important, often slowly progressing, infection in which the ED can make an important diagnosis is disseminated gonorrhea. This can be easy to miss. Consider disseminated gonorrhea for patients with polyarthritis and any signs of tenosynovitis.

Name That Fracture

A

B

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It’s Stormy

28 you F with no known PMH, p/w palpitations x 3 days after bus trip to Washington DC, states she is feeling “awful”, symptoms have been constant and worsened today.  Also endorses b/l LE swelling, nausea, vomiting x1 per day, fatigue, diaphoresis, mild SOB.  Notes generalized yellowing of skin.  Denies CP, no fevers, no cough.  No sick contacts, no travel outside of the country.

Endorses occasional etoh abuse, no tobacco, no other drug use

 

Exam:

VS: 96.6, 147, 156/56, 22, 100% RA

Gen: anxious, diaphoretic, jaundice

HEENT: +scleral icterus, mmm

CVS: irregularly irregular, tachycardic, no m/r/g

Resp: CTAB

Abd: soft, NTND, no appreciable hepatomegaly

Ext: 2+ pitting edema b/l

Neuro: A/Ox3, nonfocal

 

EKG: rapid afib

 

Notable labs:

Platelets 26

PT/PTT/INR 30/66/2.6

Tbili/Dbili 13.5/5.5

AST/ALT/AlkP 137/51/208

GGT/LDH 26/446

Lactate 4.5

Negative urine pregnancy

CXR: cardiomegaly

Biggest concern?

Continue reading “It’s Stormy” »

Chris Hansen


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