Soundings

 

It’s just been one of those nights.  It just took you three attempts to get the CSF on a patient that should have been the easiest LP in the world.  Your guidewire headed north instead of south during a subclavian vein cannulation for central venous access.  And now your charge nurse is telling you that your 85-year-old patient in the resuscitation bay is becoming more short of breath and his O2 sats are dropping. 

 

A 67-year-old man with a history of heavy ethanol and crack cocaine abuse presented to the emergency department with one day of severe generalized abdominal pain.

How to rule out DVT without a comprehensive duplex ultrasound

 

by Brian Wessman, MD PGY3,

Barnes-Jewish Hospital, Washington University Emergency Medicine Residency 

 

The patient (CR) is a 16-year-old Caucasian male with a past medical history significant for asthma (no prior intubations or hospitalizations). CR’s mother called her pediatrician’s office on a Friday morning complaining that her son had mild facial swelling in bilateral cheeks and neck.