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Fool Me Once: An Uncommon Presentation of PE
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Compensatory Reserve Index Can Aid in Early Shock Detection
EARLY SHOCK DETECTION Convertino VA, Howard JT, Hinojosa-Laborde C. Individual-specific, beat-to-beat trending of significant human blood loss: The compensatory reserve. Shock. Jan. 6, 2015. [Epub ahead of print.] Hemorrhagic shock is the leading cause of death in trauma. The challenge is detecting shock early enough to intervene clinically. The human body is masterful at compensating with a variety of seemingly undetectable mechanisms, such as autonomic activity, vasoconstriction, increased stroke volume, improved cardiac filling and more efficient breathing. So by the time we see alterations in vital sign metrics, the...
Source: JEMS Special Topics - August 10, 2015 Category: Emergency Medicine Authors: Alexander L. Trembley, NREMT P Tags: Columns Cardiac & Resuscitation Special Topics Patient Care Source Type: news