This case involves the diagnosis and management of hyperkalemia. If not treated appropriately the patient will progress to ventricular fibrillation arrest.
In this scenario, the learner is called to the ward to assess a 65-year old male with new VT. The learner must recognize the rhythm and institute appropriate work-up and management including electrical cardioversion.
This case involves the approach to the patient with acute dyspnea. The patient is tachypneic, hypoxic, and hypertensive. The team should consider multiple possibilities but recognize pulmonary edema as the most likely cause.
This case involves the approach to the patient with acute dyspnea. The patient is tachypneic but with an otherwise normal respiratory exam. ECG shows new right heart strain. The team should consider multiple possibilities but recognize PE as the most likely cause.
The resident is called to the ward to manage a patient who may have had a seizure. The patient is somnolent when the resident arrives. Shortly afterward, the patient seizes again. Two doses of anti-epileptic will be required to terminate the seizure. Finally, when the patient has been stabilized, the resident will be required to discuss the case with their staff on call.
In this case, the patient has been admitted for pneumonia and treated with the usual antibiotics. However, the team has not yet recognized that the causative bacteria is resistant to this antibiotic. The pneumonia has progressed and the team must manage the patient's respiratory distress and sepsis. The patient requires a change in antibiotics, non-invasive ventilatory support and IV fluid resuscitation.
This is a case of an elderly patient with syncope. He is found to be in third degree heart block. The team is expected to perform an initial assessment and obtain an ECG. Upon recognizing the heart block, they should ensure IV access and place pacer pads while calling for help.
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This is the sixth and final case in a six-part mini-series focusing on the management of geriatric patients in the ED. This series of cases was written by Drs. Rebecca Shaw, Nemat Alsaba, and Victoria Brazil. Dr. Rebecca Shaw is an emergency physician currently working as a medical education fellow within the Emergency Department of … Continue reading Geriatric Case 6: Elder Abuse
An 81-year old man falls down the stairs at home. He is initially asymptomatic but his level of consciousness declines and he starts to show signs of raised ICP. Providers must recognize and treat this, as well as reverse his anticoagulation, provide neuroprotective RSI and safely transport to the CT scanner. Providers must then talk with the patient’s wife, to provide information on his condition and prognosis and discuss the patient’s goals of care.