In the abdominal radiograph, a nonspecific and non-obstructive bowel gas pattern with no air-fluid level was noted, however the stomach was distended with soft tissue. The CT abdomen/pelvis revealed a distended stomach with undigested heterogeneous contents (presumed bezoar).
On the axial elbow x-ray, the radial head (red arrow) is dislocated anteriorly from the humerus; the humeroulnar articulation is intact. On the AP forearm x-ray, there is a closed, displaced, comminuted fracture of the ulna (blue arrow).
Abdominal ultrasound showed the classic presentation of the Wall-Echo-Shadow (WES) sign. The superficial aspect of the gallbladder wall is represented by a hyperechogenic curve. Below this, bile fluid is represented by hypoechogenicity. Underneath the bile fluid is the echo of the dense border created by the collection of gallstones, represented by a hyperechogenic curve. Due to the high density of the gallstones, nothing deeper can be visualized (including other gallstones or the far end of the gallbladder); this is the shadow.
Learners will 1) know the indications for each the 11 ACEP point-of-care ultrasound (POCUS) applications; 2) perform each of the 11 ACEP POCUS applications; 3) integrate POCUS into medical decision-making.
Neutropenia is a common oncologic emergency, and it frequently develops as a result of myelosuppression from chemotherapy. Neutropenia is defined as absolute neutrophil count (ANC) <1000/mm3, with severe neutropenia being defined as ANC<500/mm3. Patients with fever and neutropenia should be presumed to have infectious etiology and started on antibiotics immediately. The 48-hour mortality associated with an untreated infection is 20%-50%.
By the end of this educational session, the learner will: 1) list 10 major causes for an acute red eye; 2) describe historical features that help distinguish between benign and serious causes of the acute red eye; 3) describe physical examination features that help distinguish between benign and serious causes of the acute red eye; and 4) use historical and physical examination features to distinguish between the 10 different causes of the acute red eye.
At the end of this didactic session, the learner will be able to: 1) list the various transfusion reactions and their approximate incidence; 2) understand the pathophysiology behind each transfusion reaction; 3) describe the management for each type of transfusion reaction; and 4) discuss the plan for prevention of future transfusion reactions.
By the end of this session learners will be able to: 1) describe the underlying deficiencies of hemophilia A and B; 2) discuss the complications of hemophilia; 3) formulate an appropriate treatment plan for an acutely bleeding hemophiliac; 4) calculate the appropriate factor dosing for a hemophiliac with acute bleeding.
