Emergency Medicine blog
Clinical teaching and practical ideas for your next study session.
Adrenal Crisis in the ED: Preserve the Test, Treat Now
The key ED decision is not how to force an ACTH stimulation test into resuscitation, but how to preserve diagnostic clues without delaying hydrocortisone for an unstable patient.
Hypertensive Encephalopathy MCQs: Trace the Edema Mechanism
When an Emergency Medicine MCQ asks why cerebral edema develops with severe hypertension, trace autoregulatory failure to blood–brain barrier leak. Don’t anchor on a fixed MAP cutoff or confuse vasogenic swelling with ischemic cytotoxic edema.
ARDS on Chest X-Ray: Bilateral Opacities Are a Clue, Not the Diagnosis
In ARDS, bilateral opacities are the key imaging pattern—not a standalone diagnosis. Learn why patchy films can qualify, what the imaging criterion excludes, and why absent cardiomegaly does not prove noncardiogenic edema.
Thyroid Storm With AF and Crackles: Choose Beta-Blockade by Perfusion
In thyroid storm with AF and crackles, the key decision is not simply whether to use propranolol, but whether the circulation can tolerate beta-blockade. Learn how perfusion, cardiac assessment, and reversibility guide safer rate control.
CO Poisoning MCQs: Troponin, Confusion, and the HBO Call
A positive troponin can distract from ongoing confusion. Learn to prioritize urgent hyperbaric consultation while continuing 100% oxygen—and assess for ACS without diagnosing it from one lab.
After the Hyponatremic Seizure: Catch the Sodium Surge
A seizure may stop after hypertonic saline while sodium keeps climbing from a sudden water diuresis. Learn the urine-output clues, correction limits, and when to pause treatment or consider DDAVP and D5W.
Gustilo IIIB or IIIA? Let Periosteal Stripping Break the Tie
A 12-cm, soil-contaminated wound raises concern for a severe open fracture, but it does not decide the subtype. When a stem also describes substantial periosteal stripping with exposed bone, that points toward IIIB; learn what would favor IIIA or define IIIC.
Seven Bedside Teaching Questions: Find the Reasoning Gap
The seven prompts are not a checklist to fire at every learner. Use them selectively to locate a reasoning gap, distinguish diagnosis from action, and give one useful feedback point during an ED shift.
Hemolyzed Potassium, Sine-Wave ECG: Treat First, Verify in Parallel
A hemolyzed potassium result does not settle the diagnosis in a dialysis patient with a dangerous ECG. Learn how to stabilize immediately while getting a repeat result you can interpret.
Ottawa Ankle Rules: When a Negative Result Doesn't Apply
A patient who can walk may still need imaging—and the Ottawa Ankle Rules cannot clear every foot bone. Learn a scope-first method for interpreting this board-style question.
HELLP at 34 Weeks: Why BP 155/95 Doesn’t End the Workup
A BP of 155/95 is below severe range, but it does not close the HELLP evaluation in a 34-week patient with epigastric pain. Learn when to repeat labs and escalate.
DKA and a Positive Troponin: Injury Is Not Yet an Infarct
In DKA, an elevated troponin signals myocardial injury but does not identify its cause. Learn how serial ECGs, assay-based troponin trends, and evidence of ischemia guide ED decisions about ACS.