We have another great day of conference coming up tomorrow, but first…let’s recap last week!
Dr. Stuart Swadron discussed chest x-ray in the ED:
- Hemothorax is easy to hide in a supine patient
- COPD exacerbation can be mimicked by pneumothorax, PE, and lobar collapse
- “Things people call pneumonia”: PE, septic emboli, TB, cancer, and diffuse alveolar hemorrhage
Dr. Billy Mallon discussed necrotizing fasciitis:
- Other worrisome signs: skin necrosis, bullae, shock, dishwater drainage, tense edema, and bronzing. Beware! Often it will present early and subtly.
- MRSA is the classic cause, but group A strep, Clostridia, Vibrio, and polymicrobial infections are also common
- The LRINEC score has mixed literature, but a high WBC and low sodium should make you suspicious
- Initiate antibiotics, but surgery is the most important therapy, so call early
Dr. Neil Rifenbark updated our PEA thought process
- New approach: two steps
- Wide or narrow?
- If narrow, do a RUSH exam
- MI, PE, and pre-existing BBB can all present as wide-complex
See you tomorrow for:
History of LAC+USC with an alumni guest panel, hosted by Drs. Tabatabai and Mallon
Morbidity and Mortality Conference
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