A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
Figure 1. Index ECG notable for sinus tachycardia with S1 Q3 T3 pattern.
The Case:
A 58-year-old M with no reported PMHx presenting with shortness of breath and the following ECG. The patient endorses 1 week of exertional dyspnea that evolved to include pleuritic chest pain one hour prior to arrival. He had severe shortness of breath on awaking. He denied hemoptysis, lower extremity edema, calf pain, history of VTE, hormone use, recent surgery, or prolonged immobility.
Jose Reyes, MD
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A structurally difficult airway is something an emergency physician would prefer to avoid, and angioedema is one of the most infamous causes of a difficult airway. Here, we discuss the evaluation and management of angioedema beyond more than the procedural management.
Karlee De Monnin, MS4
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Figure 1. Clustered rash with vesicles and scabbed over lesions along C6-7 dermatome.
The Case:
An otherwise healthy 3-year-old presented to the emergency department with a chief complaint of a pruritic rash for 2 days that started on the back and progressed down the arm to the hand. The child and his family were migrants recently arriving in the United States from South America and currently staying at a migrant shelter. The patient’s blood pressure was 104/60 mmHg, heart rate 100 BPM, respiratory rate 22 BPM, oxygen saturation 97% on room air, and temperature 37ºC (98.6ºF). On examination, the child was overall well-appearing, and significant only for a crusted-over patch of lesions was noted at the C6-7 dermatome on the child’s back lateral to midline, clustered papulovesicular lesions along the outer side of the left arm and involving the left hand along the C6-7 dermatome. What is causing the patient’s rash?
Michael Hohl, MD and Alisa McQueen, MD
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