Past Issues

56 issues

Every morning issue is archived here by date. The most recent is always available at the front page.

Friday, June 12, 2026

Diarrhea

Most diarrhea is self-limited, but missed dehydration, sepsis, ischemia, toxic ingestion, or C. difficile can deteriorate quickly. The ED job is to separate nuisance from danger before giving the wrong drug to the...
Thursday, June 11, 2026

Complications of Feeding Tubes

Feeding tubes are common, and their complications range from benign clogging to life-threatening aspiration, perforation, hemorrhage, and intraperitoneal feeding. Missed complications can rapidly become ICU problems.
Wednesday, June 10, 2026

Aspiration Pneumonia

Aspiration pneumonia is a common ED diagnosis in older adults, patients with altered mental status, dysphagia, vomiting, or poor airway protection. It can range from mild community-acquired infection to severe...
Tuesday, June 9, 2026

Troubleshooting the Ventilator

Ventilator alarms are time-sensitive bedside problems: a bad tube, bad patient, or bad settings can cause immediate hypoxemia, hypercapnia, or barotrauma. EM residents need a fast, systematic way to identify life...
Monday, June 8, 2026

Pulmonary Hypertension

Pulmonary hypertension (PH) can present subtly but decompensate fast, especially with exertion, hypoxia, arrhythmia, pregnancy, or missed vasodilator therapy. In the ED, the big danger is acute right ventricular...
Sunday, June 7, 2026

Aortic Dissection: Deep Dive

Aortic dissection is a high-mortality diagnosis that is frequently missed because symptoms can mimic ACS, stroke, PE, or musculoskeletal pain. Early recognition and BP/impulse control can prevent propagation,...
Saturday, June 6, 2026

Resuscitation of Critically Ill Child

Pediatric deterioration is usually preceded by subtle compensatory changes, and kids crash fast once reserve is exhausted. Early recognition, age-appropriate resuscitation, and rapid team coordination can prevent...
Friday, June 5, 2026

AICD

ICD patients may present after shocks, syncope, or cardiac arrest, and the ED job is to distinguish an appropriate lifesaving shock from device malfunction or an arrhythmic/infectious trigger. A normal-looking...
Thursday, June 4, 2026

Approach to Undifferentiated Shock

Shock kills fast, and the first minutes determine whether the patient recovers or spirals into arrest. The challenge is recognizing the shock state early, then rapidly classifying it into distributive, hypovolemic,...
Wednesday, June 3, 2026

Bradydysrhythmias

Bradycardia can be benign, but in the wrong patient it’s a marker of impending shock, high-grade AV block, or reversible toxic/metabolic disease. The ED job is to identify instability, treat symptoms fast, and not...
Tuesday, June 2, 2026

Chest Pain: Deep Dive

Chest pain is one of the highest-stakes ED complaints because time-sensitive diagnoses can look deceptively similar early on. The job is not to “rule out ACS” only — it’s to rapidly sort life-threatening cardiac,...
Monday, June 1, 2026

Procoagulant States

Hypercoagulability can present anywhere in the ED: DVT/PE, stroke, mesenteric ischemia, limb ischemia, recurrent pregnancy loss, or unexplained thrombosis. Recognizing the underlying procoagulant state changes both...
Sunday, May 31, 2026

Blast Crisis

Blast crisis is an oncologic emergency most often representing transformation of chronic myelogenous leukemia (CML) into an acute leukemia. It can present with hyperleukocytosis, cytopenias, infection, leukostasis,...
Saturday, May 30, 2026

Adult and Pediatric Medical Malpractice

Malpractice cases are high-stakes because the ED is a common source of claims, and both adult and pediatric errors often involve time-sensitive diagnoses, communication failures, or documentation gaps. Board-style...
Friday, May 29, 2026

Retropharyngeal Abscess

Retropharyngeal abscess is a deep neck space infection that can rapidly progress to airway compromise, mediastinitis, sepsis, or carotid complications. It’s classically a pediatric disease, but adults can get it too,...
Thursday, May 28, 2026

Otitis Externa / Malignant Otitis Externa

Otitis externa is a common ED complaint, but malignant otitis externa is a skull-base osteomyelitis that can cause cranial neuropathies, intracranial spread, and death if missed. The key ED job is distinguishing a...
Wednesday, May 27, 2026

Infectious Ear Emergencies

Ear infections can look benign but occasionally represent rapidly progressive disease, deep space spread, or complications like hearing loss, facial nerve palsy, labyrinthitis, or intracranial extension. The ED job...
Tuesday, May 26, 2026

Central Retinal Vein Occlusion

CRVO is a vision-threatening retinal vascular event causing sudden painless monocular vision loss. ED priority is distinguishing it from CRAO, retinal detachment, vitreous hemorrhage, acute glaucoma, and GCA-related ischemia.
Monday, May 25, 2026

Approach to Ear Pain

Ear pain is often benign, but it can also be the first clue to mastoiditis, malignant otitis externa, zoster oticus, dental infection, temporal arteritis, or a deep head-and-neck process. The first job is...
Sunday, May 24, 2026

T Wave Inversion in the Anterior Leads

Anterior T-wave inversion can be benign, but in the ED it may signal high-risk LAD ischemia, pulmonary embolism, CNS catastrophe, or structural heart disease. Missing Wellens syndrome is a classic board and...
Saturday, May 23, 2026

Prehospital Management of Cardiac Arrest and Interface with Regionalized Systems of Care

Outcomes from cardiac arrest are determined before the patient reaches the ED: early CPR, early defibrillation, high-quality ALS, and correct destination planning. EM physicians must understand EMS workflows to...
Friday, May 22, 2026

Endophthalmitis

A true ophthalmologic emergency: infection/inflammation inside the globe can cause irreversible vision loss within hours to days. ED priority is rapid recognition, vision assessment, pain control, and immediate...
Thursday, May 21, 2026

Automated Internal Cardioverter-Defibrillators

AICDs prevent sudden cardiac death but create ED problems: shocks, device malfunction, inappropriate therapy, infection, and “VT storm.” The ED priority is determining whether shocks are appropriate, stabilizing the...
Wednesday, May 20, 2026

Urological Trauma

GU injuries often occur with high-energy trauma and can be missed if evaluation stops at “gross hematuria.” The major ED pitfall is placing a Foley in a patient with urethral injury before performing a retrograde urethrogram.
Tuesday, May 19, 2026

Postpartum Hemorrhage

Postpartum hemorrhage (PPH) is a leading cause of maternal death and can progress rapidly from “normal delivery bleeding” to shock. In the ED, early recognition, uterine massage, uterotonics, TXA, and massive...
Monday, May 18, 2026

Ovarian Pathology

Ovarian emergencies can mimic appendicitis, renal colic, PID, or ectopic pregnancy. The ED must rapidly identify torsion, hemorrhagic cyst rupture, tubo-ovarian abscess, and pregnancy-related mimics because delayed...
Sunday, May 17, 2026

Male GU Emergencies

Male GU complaints can hide time-critical diagnoses: testicular torsion, Fournier gangrene, ischemic priapism, penile fracture, and obstructive urinary retention. Early recognition prevents testicular loss, erectile...
Saturday, May 16, 2026

Chest Pain in Pregnancy

Pregnancy increases risk for PE, aortic dissection, spontaneous coronary artery dissection, cardiomyopathy, and ACS mimics. Do not dismiss chest pain as “normal pregnancy” — missed PE or ACS is a major cause of...
Friday, May 15, 2026

Tutorial: General Principles of Musculoskeletal Ultrasound

MSK ultrasound is fast, dynamic, bedside, and radiation-free. In the ED it can identify tendon rupture, joint effusion, foreign body, abscess vs cellulitis, muscle tear, and guide procedures.
Thursday, May 14, 2026

Subungual Hematoma Evacuation

Subungual hematomas are common after crush injuries and can be exquisitely painful due to pressure under the nail plate. The key ED task is pain relief while not missing an associated distal phalanx fracture or...
Wednesday, May 13, 2026

Ring Removal

A tight ring can become a tourniquet, causing venous congestion → worsening edema → arterial compromise, nerve injury, and possible digit loss. Early removal is often simple; delayed removal can require cutting or...
Tuesday, May 12, 2026

Phalanx Fractures

Finger fractures look benign but can cause permanent stiffness, rotational deformity, tendon dysfunction, and impaired hand function if missed or splinted incorrectly.
Monday, May 11, 2026

Paronychia and Felon

Common fingertip infections can progress quickly in closed spaces. A missed felon can cause pressure necrosis, osteomyelitis, flexor tenosynovitis, or permanent sensory loss.
Sunday, May 10, 2026

Metacarpal Fractures

Metacarpal fractures are common ED hand injuries; missed malrotation or unstable patterns can cause permanent grip dysfunction. Most are splinted and discharged, but open fractures, intra-articular injuries, CMC...
Saturday, May 9, 2026

Flexor Tenosynovitis

Pyogenic flexor tenosynovitis is a closed-space infection of the flexor tendon sheath that can rapidly cause tendon necrosis, adhesions, loss of digit function, and sepsis. It is a hand-surgery emergency.
Friday, May 8, 2026

Felon Incision and Drainage

A felon is a closed-space infection of the distal fingertip pulp. Delayed drainage can cause pressure necrosis, osteomyelitis, flexor tenosynovitis, or permanent sensory loss.
Thursday, May 7, 2026

Carpal Tunnel Syndrome

Most common compressive neuropathy; ED role is recognizing median nerve dysfunction, excluding mimics/red flags, initiating symptom control, and arranging follow-up before permanent thenar weakness develops.
Wednesday, May 6, 2026

The Suicidal Patient

Suicide risk assessment is a core ED competency; missed risk can be fatal, and inappropriate discharge creates major patient-safety and medicolegal risk. ED goals are safety, medical stabilization, identification of...
Tuesday, May 5, 2026

Opioid Toxicity and Poisoning

Opioid overdose is a rapidly reversible cause of coma, respiratory failure, and death. ED management is airway-first, with naloxone titrated to ventilation—not necessarily full arousal.
Monday, May 4, 2026

Intracerebral Hemorrhage

ICH is a high-mortality stroke syndrome where early ED actions — BP control, anticoagulation reversal, airway/ICP management, and neurosurgical triage — directly affect outcome.
Sunday, May 3, 2026

Ethanol Intoxication, Toxicity and Poisoning

Ethanol intoxication is common, but “just drunk” is a dangerous anchoring trap. Hypoglycemia, trauma, co-ingestions, sepsis, toxic alcohols, and intracranial pathology can all mimic or coexist with ethanol intoxication.
Saturday, May 2, 2026

Cervical Artery Dissection

Carotid and vertebral artery dissections are major causes of stroke in younger adults and can present subtly with headache/neck pain before neurologic deficits. Early recognition changes management: stroke...
Friday, May 1, 2026

Aneurysmal Subarachnoid Hemorrhage

Aneurysmal SAH is a high-mortality cause of sudden severe headache where early missed diagnosis leads to rebleeding, hydrocephalus, vasospasm, herniation, and death. ED priorities are rapid diagnosis, BP control,...
Thursday, April 30, 2026

Syphilis

Syphilis is “the great imitator” and can present with genital ulcers, rash, neurologic symptoms, ocular complaints, or pregnancy complications. Missing neurosyphilis, ocular syphilis, or congenital risk has major morbidity.
Wednesday, April 29, 2026

Influenza

Influenza causes seasonal surges of ED visits and can rapidly decompensate high-risk patients via viral pneumonia, secondary bacterial pneumonia, myocarditis, encephalitis, or COPD/asthma exacerbations. Early...
Tuesday, April 28, 2026

Epstein-Barr Virus (EBV)

EBV infectious mononucleosis is common in adolescents/young adults and can mimic strep pharyngitis, acute HIV, lymphoma, or hepatitis. ED priorities are airway assessment, hydration/pain control, avoiding unnecessary...
Monday, April 27, 2026

Critical Fungal Infections

Life-threatening fungal infections are uncommon in the average ED, but missing them in the immunocompromised, critically ill, or post-influenza patient can be fatal. Early recognition matters because definitive...
Sunday, April 26, 2026

Procedural Sedation

Procedural sedation is core EM practice: it enables painful procedures, reduces distress, and can avoid the OR. Safe sedation requires anticipating airway/respiratory compromise, choosing the right agent, and...
Saturday, April 25, 2026

Hydrocarbons and Inhaled Agents Toxicity and Poisoning

These exposures are common, especially in children, industrial workers, and patients with substance use. The immediate threats are airway injury, aspiration pneumonitis, dysrhythmia, hypoxia, and end-organ toxicity...
Friday, April 24, 2026

Upper GI Bleeding

Upper GI bleeding (UGIB) ranges from self-limited mucosal bleeding to life-threatening hemorrhagic shock. Early risk stratification, resuscitation, and targeted therapy reduce mortality, rebleeding, and missed...
Thursday, April 23, 2026

Esophageal Rupture

Boerhaave syndrome is rare but rapidly fatal if missed; delayed diagnosis sharply increases mediastinitis, sepsis, and mortality. In the ED, it can masquerade as ACS, perforated ulcer, PE, or spontaneous pneumothorax.
Wednesday, April 22, 2026

Approach to Gastrointestinal Bleeding

GI bleeding ranges from self-limited to immediately fatal. The ED job is to rapidly identify shock, localize likely source (upper vs lower), start resuscitation, and choose the right consult/admission pathway.
Tuesday, April 21, 2026

Salicylate Poisoning

Salicylate toxicity is a classic mixed acid-base disorder that can deteriorate quickly, especially in older adults, children, and patients with delayed recognition. Severe poisoning causes CNS injury, pulmonary...
Monday, April 20, 2026

Digoxin Toxicity and Poisoning

Digoxin toxicity can cause life-threatening dysrhythmias, hyperkalemia, and hemodynamic collapse. The presentation is often subtle, and management hinges on early recognition plus timely Fab administration.
Sunday, April 19, 2026

Extravasation

Extravasation can range from mild local irritation to tissue necrosis, compartment syndrome, and permanent functional loss. Rapid recognition in the ED can prevent severe morbidity, especially with vesicants like...
Saturday, April 18, 2026

Wound Management

Wound care is one of the most common ED tasks and has major implications for infection, cosmesis, tetanus prevention, and function. Good irrigation, closure choice, and timely recognition of high-risk wounds prevent...