Practice Management
Urgent message: Ectopic pregnancy must be considered in women of childbearing age who present with abdominal pain—even if ‘ruled out’ by a negative hCG test. Yi-An A. Lee, MD, MPH, Gino Farina, MD, and Helene Lhamon, MD The incidence of ectopic pregnancy is estimated to be 19.7 per 1,000 pregnancies and is responsible for 9% of pregnancy-related deaths.1 Ectopic pregnancy is always near the top of the differential diagnosis for abdominal pain in women of …
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Urgent message: Clinicians must be prepared for the possibility of supraventricular tachycardia after administration of nebulized albuterol in patients of any age, especially in the presence of heart disease. Muhammad Waseem, MD, Padma Gadde, MD, and Gerard Devas, MD Asthma is the most common lung disease in children. Five percent of children in the United States have asthma, and status asthmaticus—the leading cause of admission due to asthma exacerbation—accounts for approximately 10% of visits to …
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Urgent message: Noting ‘red flags’ specific to the individual patient is of key importance when details of the presentation do not add up. Jill Chavinson Miller, MD J.W. is a 55-year-old female non-smoker who presented with abdominal pain. She reported that the pain woke her up the night before and lasted all day long, which prevented her from doing much that day. She described the pain as constant and gnawing, assessing its severity as 6 …
Read MoreM.J. is a 12-year-old African American female who presented with trouble “taking a breath” which was abrupt in onset, starting two hours prior to presenting and accompanied with abdominal pain and fatigue which resolved prior to her visit. Dyspnea was constant and not related to position. There were no alleviating or aggravating factors. Observations and Findings Patient was alert and in no distress and spoke in full sentences. Pmhx: bronchitis one year prior; no asthma, …
Read MoreMr. J.V. is a 28-year-old white male who presented to urgent are with a six-hour history of chest pain described as pressure in the sternal area radiating to the left shoulder; back pain was a 5/10 at time of visit, and constant with no accompanying nausea, dizziness, vomiting, or diaphoresis. The patient described an inability to breathe deeply and a sensation of water stuck in the mid esophagus when drinking. Of note, he had similar …
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