A 49-year-old male with no reported past medical history presents to the emergency department (ED) with a 5-day history of chest pain. He reports a history of intense, substernal chest pain yesterday that was unrelieved, leading him to schedule a clinic appointment for the next day. At the clinic, his primary care doctor advised him to come straight to the ED after completing a “strange EKG.” On arrival in the ED, the patient denies any active chest pain in triage. However, he states that he has some mild pain in the middle of his upper back, “probably just from mowing my lawn the other day.”
Austin Reynolds, DO; Michael Hohl, MD; Taylor Wahrenbrock, MD; Ari Edelheit, MD
Read MoreLacerations are among the most frequently treated injuries in pediatric emergency care. The process of repairing these injuries can provoke considerable anxiety in children, which may lead to heightened pain, difficulty completing the procedure, and negative psychological and clinical effects (1-6). Midazolam is widely used to manage procedural anxiety in children, with intranasal administration gaining popularity in recent years. A recent study by Martin et al. explored both clinical and child-specific factors that may influence the effectiveness of intranasal midazolam (7).
Taylor Wahrenbrock, MD; Samson Frendo, MD; Eric Leser, MD; Joanne Routsolias, PharmD
Read MoreA 64-year-old male with a past medical history of atrial fibrillation on rivaroxaban (but not taking rivaroxaban for the past one week), myocardial infarction with multiple prior stents placed, heart failure with reduced ejection fraction, and hypertension presents to the emergency department (ED) with palpitations, dizziness, chest pain, and shortness of breath since 5:00 PM. At the time of initial assessment, the patient reports that his dizziness, chest pain, and shortness of breath have greatly improved since earlier tin the day and nearly resolved, though he is still having palpitations. An ECG is obtained immediately upon his arrival (Figure 1).
Taylor Wahrenbrock, MD; Michael Hohl, MD; Ari Edelheit, MD
Read More
