A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
Every single Emergency Department in the United States treats unhoused patients on a daily basis, and their needs vary greatly from ICU level care to the common cold. According to the National Alliance to End Homelessness, in January 2023, there were an estimated 653,104 people experiencing homelessness on a given night (1).
Amanda Dahl MD and Rashid Kysia MD
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Bedside Clinical Question: How to interpret elevated PT/INR/PTT levels in patients on DOAC's and do we need reverse the patient based on elevated levels?
Alejandra Alvarez, PharmD & Joanne C. Routsolias, PharmD
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Figure 1. Index EKG from Cardiology Clinic
A 56-year-old female with a past medical history of seronegative rheumatoid arthritis, fibromyalgia, hypothyroidism, and asthma presents to the emergency department for concern of "abnormal EKG" from the cardiology clinic. The patient states that she was previously told she has bradycardia and does endorse the occasional symptoms of palpitations, lightheadedness, and shortness of breath. She has a remote history of a stress test that was normal. The vital signs at time of assessment are shown: BP 151/74, HR 55, RR 20, O2 Sat 98% on room air. Laboratory testing in the emergency department is unremarkable and a chest x-ray showed no acute cardiopulmonary process. The patient had an EKG (Figure 1) completed in cardiology clinic.
Erica Dolph, MD, Michael Hohl, MD, and Ari Edelheit MD
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