Past Issues

117 issues

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

Wednesday, August 12, 2026

Child Abuse

Missed inflicted injury can lead to recurrent, more severe harm, including fatal head trauma. The ED must protect the child while preserving a careful, objective medical evaluation.
Tuesday, August 11, 2026

Shock and Trauma

Trauma patients die from shock through a narrow window in which hemorrhage, airway failure, tension physiology, and obstructive causes remain reversible. The crucial skill is recognizing when resuscitation must...
Monday, August 10, 2026

Cervical Spine Clearance Part Deux

Missed cervical instability can convert a neurologically intact trauma patient into a patient with permanent paralysis. Over-imaging and prolonged collars, however, cause radiation exposure, pressure injury,...
Sunday, August 9, 2026

Spinal Cord Injuries

A high cervical injury can convert a talking patient into an apneic one within minutes. Missed neurogenic shock, hypoxia, or secondary cord injury causes preventable neurologic loss.
Saturday, August 8, 2026

Nasal Bone Fractures

Most isolated nasal fractures need clinical diagnosis and outpatient care, but an unrecognized septal hematoma can cause cartilage necrosis, saddle-nose deformity, and infection. The dangerous question is not “Is the...
Friday, August 7, 2026

FACIAL TRAUMA OVERVIEW

Facial trauma can conceal a failing airway, intracranial injury, orbital catastrophe, and major hemorrhage behind dramatic but distracting wounds. The key is to identify the injury that kills first, not the fracture...
Thursday, August 6, 2026

Perirectal Abscess

A perirectal abscess can progress to sepsis, necrotizing infection, fistula, or pelvic extension while remaining occult on surface examination. Antibiotics alone rarely cure a mature abscess; drainage and source...
Wednesday, August 5, 2026

G Tube Tips and Tricks

A mature tract can often be salvaged quickly, but an immature tract can create intraperitoneal feeding, peritonitis, and catastrophic sepsis. The tube’s age, not its appearance, determines whether replacement is safe.
Tuesday, August 4, 2026

Esophageal Perforation

Esophageal perforation rapidly converts a local injury into mediastinitis, sepsis, and multiorgan failure. Mortality rises sharply when diagnosis and source control are delayed, especially beyond the first 24 hours.
Monday, August 3, 2026

Esophageal Rupture

Esophageal rupture rapidly converts a contained leak into mediastinitis, sepsis, shock, and death. Early recognition, broad-spectrum therapy, and surgical control of contamination determine survival.
Sunday, August 2, 2026

Massive Hemoptysis

The usual cause of death is not exsanguination but asphyxiation from blood obstructing the airway or flooding the opposite lung. Management is a race to oxygenate, isolate the bleeding side, and obtain bronchial...
Saturday, August 1, 2026

Pertussis

Pertussis can cause apnea, hypoxemia, pneumonia, and death in young infants while appearing deceptively mild in older children and adults. Early recognition protects vulnerable contacts and prevents prolonged transmission.
Friday, July 31, 2026

Rural Medicine: Bariatric Airway

Obesity reduces oxygen reserve, increases difficult-mask-ventilation risk, and makes failed airway rescue physically and technically harder. In a rural setting, the airway must be secured with the equipment and...
Thursday, July 30, 2026

Pulmonary HTN and Sleep Apnea

Obstructive sleep apnea can produce chronic hypoxemia, sympathetic surges, and pulmonary vascular remodeling, but acute dyspnea may instead reflect pulmonary embolism, left-heart failure, or decompensated pulmonary...
Wednesday, July 29, 2026

Bronchitis

Acute bronchitis is usually viral and self-limited, but pneumonia, asthma, COPD exacerbation, and pertussis can require different management. Unnecessary antibiotics create adverse effects, resistance, and false...
Tuesday, July 28, 2026

Pneumomediastinum

Most spontaneous cases are benign, but missed esophageal or tracheobronchial injury can progress rapidly to mediastinitis, sepsis, and death. The management fork is not “air present or absent”; it is whether a...
Monday, July 27, 2026

Aspiration Pneumonia

Aspiration can produce anything from transient chemical injury to necrotizing infection, respiratory failure, and empyema. The dangerous error is treating every witnessed aspiration with antibiotics—or missing the...
Sunday, July 26, 2026

PE in Pregnancy

PE is a leading cause of maternal death, and pregnancy both increases thrombotic risk and degrades the usual clinical signal. Delayed diagnosis harms two patients; indiscriminate imaging and anticoagulation create...
Saturday, July 25, 2026

A Broken Heart

Takotsubo syndrome can produce cardiogenic shock, pulmonary edema, LV outflow obstruction, ventricular arrhythmias, and mural thrombus while initially resembling STEMI. Missing the diagnosis—or assuming it is...
Friday, July 24, 2026

Hypertensive Emergencies Part 2

The number alone is not the emergency; acute end-organ injury is. Reducing pressure too quickly—or choosing a drug that increases shear or intracranial pressure—can convert a dangerous presentation into an irreversible one.
Thursday, July 23, 2026

Thoracic Aortic Aneurysms

Thoracic aortic aneurysms may remain silent until rupture, dissection, airway compromise, or coronary malperfusion occurs. A “stable” patient can deteriorate abruptly, and delay in definitive repair is often the fatal error.
Wednesday, July 22, 2026

Brugada Updates

Brugada syndrome is an arrhythmic substrate in which fever, sodium-channel blockade, and autonomic shifts can precipitate ventricular fibrillation and sudden death. The ECG may be intermittent, and a normal tracing...
Tuesday, July 21, 2026

Congenital Long QT

Congenital long QT syndrome can convert a seemingly benign syncopal episode into torsades de pointes and sudden death. The diagnosis is often missed because the patient rapidly returns to baseline and the ECG may be...
Monday, July 20, 2026

Endocarditis

Endocarditis can quietly destroy valves, seed the brain and spine, and produce septic shock or heart failure. The crucial errors are delaying cultures and antibiotics—or treating the infection while missing a...
Sunday, July 19, 2026

Hypertrophic Obstructive Cardiomyopathy

Dynamic LV outflow obstruction can turn modest volume loss or tachycardia into profound shock and sudden death. The lifesaving strategy is counterintuitive: slow the heart, support afterload, and preserve preload.
Saturday, July 18, 2026

Recurrent Low-Risk Chest Pain

Repeated negative evaluations can expose patients to unnecessary radiation, admissions, and anxiety—but premature closure can miss evolving ACS, especially when symptoms change. The goal is not “rule out everything”;...
Friday, July 17, 2026

Low Risk Chest Pain

Most ED chest pain is benign, but a small number of missed acute coronary syndromes cause preventable morbidity and litigation. The goal is not to prove “no cardiac disease”; it is to identify patients with...
Thursday, July 16, 2026

ACS Special Considerations

ACS is frequently painless, electrically subtle, or complicated by bleeding risk, renal disease, heart failure, or cardiogenic shock. Missing the atypical or high-risk patient delays reperfusion; applying a protocol...
Wednesday, July 15, 2026

Cognitive Challenges in EBM

Emergency physicians make high-stakes decisions under time pressure, uncertainty, interruption, and emotional load. Recognizing predictable cognitive errors helps you use evidence as a safeguard rather than...
Tuesday, July 14, 2026

MENINGOCOCCEMIA

Meningococcemia can progress from a nonspecific febrile illness to purpura fulminans, refractory shock, adrenal hemorrhage, and death within hours. Early antibiotics and shock resuscitation are more important than...
Monday, July 13, 2026

PURPURIC RASHES

Purpura may be benign vascular leakage—or the visible surface of meningococcemia, DIC, TTP, or catastrophic thrombocytopenia. The fatal error is waiting for a complete laboratory explanation while an immediately...
Sunday, July 12, 2026

APPROACH TO JAUNDICE IN ADULTS

Jaundice ranges from benign medication effects to ascending cholangitis, acute liver failure, and obstructing malignancy. The critical error is delaying source control or missing synthetic failure while focusing only...
Saturday, July 11, 2026

Anticoagulant Reversal

Intracranial, retroperitoneal, airway, and hemodynamically significant bleeding can deteriorate within minutes. Reversal is a race between ongoing hemorrhage, delayed antidote administration, and thrombosis from...
Friday, July 10, 2026

Diving Injuries

Diving injuries can look deceptively benign at first and then evolve into neurologic catastrophe, arterial gas embolism, or pulmonary injury. The difference between “observe” and “hyperbaric now” is often the dive...
Thursday, July 9, 2026

Hypomagnesemia

Magnesium deficiency is a common, underrecognized trigger for arrhythmias, refractory hypokalemia, and refractory hypocalcemia. Missing it means repeatedly “treating the lab” while the real problem keeps the patient unstable.
Wednesday, July 8, 2026

Thyroid Storm and Hyperthyroidism

Thyroid storm kills by multisystem failure, dysrhythmia, and hyperthermic decompensation. Missing it turns a reversible endocrine crisis into an ICU disaster.
Tuesday, July 7, 2026

Opioid Use Disorder and Dependence

OUD is common, deadly, and often presents to the ED through withdrawal, overdose, pain, or “just needing help.” The ED visit is a high-yield chance to reduce withdrawal, start evidence-based treatment, and prevent...
Monday, July 6, 2026

Conversion Disorder

This diagnosis is common, easy to mishandle, and often triggered by a high-stakes neurologic mimic. Missing an organic cause harms patients; mishandling the conversation can lock in disability and repeat ED use.
Sunday, July 5, 2026

Non-Pregnant Vaginal Bleeding

Most non-pregnant vaginal bleeding is benign, but missed hemorrhage, malignancy, or torsion-equivalent pathology can spiral fast. The ED job is not to “explain” every bleed — it is to stabilize, localize, and...
Saturday, July 4, 2026

Nausea, Vomiting and Hyperemesis in Pregnancy

Persistent vomiting in pregnancy can quietly become dehydration, electrolyte derangement, malnutrition, and Wernicke encephalopathy. Missing an alternate diagnosis — or under-treating hyperemesis — harms both parent...
Friday, July 3, 2026

Nephrotic Syndrome

Nephrotic syndrome is easy to miss because the chief complaint is often just edema. The ED job is to identify the syndrome, screen for complications, and catch the thrombotic or infectious patient before they deteriorate.
Thursday, July 2, 2026

Epididymitis

This is a common cause of acute scrotal pain, but the dangerous miss is testicular torsion. Get the triage right, treat the right pathogen set, and don’t send home the patient who is already abscessing or systemically ill.
Wednesday, July 1, 2026

Snakebites (USA)

Most US snakebites are not fatal, but the dangerous ones are time-sensitive and easy to under-treat or over-treat. Missing evolving envenomation, or mismanaging antivenom and coagulopathy, costs limb function and...
Tuesday, June 30, 2026

Opioid Toxicity and Poisoning

Opioid poisoning kills by hypoventilation, not by the drug name on the label. The trap is missing the airway problem or undertreating the duration of action.
Monday, June 29, 2026

High-Pressure Injection Injuries

These injuries are easy to dismiss and catastrophic to miss. The visible skin wound may be trivial while the true injury is chemical, infectious, and ischemic destruction of the hand.
Sunday, June 28, 2026

Wrist Fracture / Wrist Dislocations

Missed wrist dislocations and perilunate injuries can rapidly cost median nerve function and carpal viability. A “simple fall” can become a hand-salvage emergency if the reduction is delayed or incomplete.
Saturday, June 27, 2026

Elbow Fractures / Elbow Dislocations

Missed elbow instability can cost a limb functionally or vascularly, even when the skin looks intact. The key job in the ED is to identify dislocation, associated fracture, and neurovascular compromise fast enough to...
Friday, June 26, 2026

Aneurysmal Subarachnoid Hemorrhage

Aneurysmal SAH kills early from rebleeding and later from delayed ischemia. Missing it means sending home a patient whose second bleed may be the fatal one.
Thursday, June 25, 2026

Infections of the Spinal Column

Missed spinal infection can progress from back pain to irreversible paralysis, spinal instability, bacteremia, and death. The key is to recognize when “back pain” is actually a source-control problem with neurologic stakes.
Wednesday, June 24, 2026

Guillain-Barre Syndrome

GBS can look deceptively “stable” until respiratory failure or autonomic collapse appears. The ED job is to recognize the pattern early, measure function objectively, and admit the right patient before the diaphragm quits.
Tuesday, June 23, 2026

Infantile Hypertrophic Pyloric Stenosis

This is a common surgical diagnosis in young infants and a classic board question. Missing the volume depletion and metabolic derangement can make an otherwise straightforward case much more dangerous.
Monday, June 22, 2026

TMJ Disorders

TMJ complaints are common, under-triaged, and easy to confuse with dental, ear, traumatic, or cardiac pain. Missing true dislocation or a dangerous mimic can prolong pain, delay reduction, or overlook serious pathology.
Sunday, June 21, 2026

Keratitis and Corneal Ulcers

Keratitis and corneal ulcers can scar the visual axis, perforate the cornea, and blind a patient if treatment is delayed. Contact lens–associated infections are common, aggressive, and easy to under-triage.
Saturday, June 20, 2026

Retinal Detachment and Defects

Retinal detachment is a time-sensitive cause of irreversible vision loss. The resident’s job is to recognize it early, protect the eye, and get the right ophthalmology response without delay.
Friday, June 19, 2026

Infections of the Spinal Column: Spinal Epidural Abscess

Spinal epidural abscess is a can’t-miss diagnosis because neurologic injury can become irreversible fast. Delay means paralysis, sepsis, and a missed window for decompression.
Thursday, June 18, 2026

Critical Fungal Infection

Invasive fungal infection is a time-sensitive diagnosis: delays allow angioinvasion, tissue necrosis, and death. The emergency job is to recognize the host risk, start the right antifungal, and move fast on source control.
Wednesday, June 17, 2026

Mass Gathering Medicine and Triage

Mass gatherings can overwhelm EMS and ED flow in minutes. A bad triage decision delays care for the sickest patients and can turn a manageable scene into a preventable disaster.
Tuesday, June 16, 2026

Geriatric Trauma

Older adults die from trauma at lower energy thresholds and with deceptively normal initial vitals. The trap is under-triage, delayed imaging, and missing occult hemorrhage, head injury, or medication-related bleeding.
Monday, June 15, 2026

Penetrating Neck Injuries

Penetrating neck trauma can look deceptively minor while hiding fatal vascular, aerodigestive, or airway injury. The missed injury is often not the wound you can see, but the vessel or airway you don’t.
Sunday, June 14, 2026

Penetrating Abdominal Trauma

The abdomen can hide lethal injury behind a tiny skin defect. Missing a hollow viscus or vascular injury is how a “stable” patient becomes a catastrophe.
Saturday, June 13, 2026

Malrotation/Midgut Volvulus

Midgut volvulus can infarct the bowel fast; the window to save intestine and life is narrow. Missing it is one of the classic catastrophic pediatric abdominal failures.
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...