A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
Figure 1. Index ekg obtained from triage in the CCH emergency department.
The Case:
49-year-old female with a past medical history of anxiety presenting with central sternal chest pressure, which she describes as sharp that started 3 hours prior to arrival. The pain is non-radiating and not associated with exertion, emesis, or diaphoresis, but she does feel like she is going to pass out. She says when she has had panic attacks before, she had chest pain. Vitals were BP 124/72 mmHg, HR 59 bpm, RR 18 bpm, and Spo2 98% on RA.
Alejandro Negrete, MD
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Image Source: https://transformpeds.childrensmercy.org/food-insecurity-screening-in-the-allergy-specialty/
Food insecurity has many implications for patients, including associations with frequent ED use, foregoing medication to afford food, and worsening control of chronic medical conditions. Screening for food insecurity is a potential tool for EPs to utilize to improve patient outcomes, assist in adherence to treatment plans, and reduce ED utilization.
Michael Hohl, MD and Rashid Kysia, MD
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Image Source: Image by vectorjuice at www.freepik.com
The Case:
A 48 yo M with a past medical history of hypertension and heroin use disorder presents to the Emergency Department (ED) with body aches and vomiting since this morning in the context of 14 hours since last heroin used. You note the patient is diaphoretic and restless with moderately dilated pupils, rhinorrhea, and a slight tremor. You are concerned the patient is in withdrawal. He is interested in getting into a medication-assisted treatment (MAT) program; however, he is currently undomiciled and does not know if he can follow up outpatient tomorrow. Here we discuss options to treat the patient's withdrawal and help bridge to outpatient MAT.
Taylor Wahrenbrock, MD and Michael Nelson, MD
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