The Heart Of The Matter - A Case of Routine Hemodialysis

February 21, 2025

A 59-year-old female with past medical history of hypertension, type 2 diabetes mellitus, end-stage renal disease (ESRD) on hemodialysis (HD) presented to the emergency department (ED) with a request for routine HD (note: Cook County Hospital has a cohort of patients who routinely receive their HD via the emergency department rather than through an outpatient clinic). Initial vital signs were notable for hypertension but were otherwise unremarkable. The patient denied any symptoms, but reported that her last HD session was more than a week ago. The Renal service was consulted for HD and recommended obtaining labs given her missed HD sessions. The potassium level returned at 8.7 (not hemolyzed).

Alexandra Atkins, MD and Ari Edelheit, MD

**Figure 1.** Procedural sedation agents (courtesy of EMRA).

The Cheese - Procedural Sedation in the Emergency Department

February 14, 2025

Procedural sedation is a unique skill that is frequently utilized by Emergency Medicine (EM) trained physicians. Depending on the indication and patient’s clinical status, it can be both stressful and time consuming, but ultimately a procedure that must be mastered to facilitate safe and effective care for our patients. Let’s start with the basic steps and setup and finish with some article reviews.

Kathryn McGregor, MD; Taylor Wahrenbrock, MD; Eric Leser, MD

The Heart Of The Matter - A Case of Nausea and Vomiting

February 7, 2025

A 63-year-old male with a past medical history of epilepsy, hypertension, and papillary thyroid carcinoma s/p left hemithyroidectomy presents with nausea and vomiting. The patient reports that, around 2:00 AM, he woke up from his sleep and began sweating and vomiting. These symptoms have continued intermittently since then, and the patient presents with his wife around 5:00 PM. He reports epigastric discomfort but denies any fevers, chills, chest pain, palpitations, or shortness of breath.

Taylor Wahrenbrock, MD; Michael Hohl, MD; Ari Edelheit, MD

the County Consult