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Sinaiem dark
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18

lump-in-my-throat

A 19-year-old-male with no known past medical history, presents in progressive respiratory distress shortly after undergoing a tooth extraction about 6 hours prior to presentation. Symptoms began initially as “a lump in his throat” and difficulty swallowing, but eventually progressed to mild dyspnea after 1-2 hours. Denies FB or allergies. On arrival he appears anxious and is breathing at 18 breaths per minute with an O2 saturation of 100%. There is no stridor at presentation. There is no intra-oral, facial, or obvious neck swelling. There is no skin involvement or abdominal pain, nausea, vomiting or diarrhea. You suspect allergic reaction and give IM epi, IV steroids, benadryl and pepcid. ENT is consulted for scope.  
sinaiem.org
about 5 years ago
Sinaiem dark
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10

i-cant-see

32 year old male with history of HTN, presents to your ED complaining of progressive R eye pain and decreased visual acuity after a wooden plank stuck him in the face at work about 2 hours prior. He denies other injuries, denies LOC, denies vomiting, focal neurological deficit, and takes no anticoagulation medications. Vitals normal with GCS 15.  
sinaiem.org
about 5 years ago
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19

Podcast #12: Oh Dance-a-tron (Ondansetron for Pediatric Vomiting)

Dehydration in children is a common presentation to the emergency department. A main cause of dehydration in this age group is gastroenteritis which is charaterized by acute onset diarrhea with or without nausea, vomiting, fever and abdominal pain. The scope of the problem was quantified by Glass in 1991. This study showed the following:  
thesgem.com
about 5 years ago
Sinaiem dark
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5

bloated-and-upset

47 y/o female PMH appendectomy presents with three days of worsening abdominal pain and constipation. Over the past day she has had persistent vomiting. She appears ill and has a diffusely tender abdomen. You quickly order labs and an obstructive series with upright chest XR with concern for a perforated viscus. To your surprise the CXR shows no signs of air under the diaphragm. Are there other signs of pneumoperitoneum could you look for on abdominal films?  
sinaiem.org
about 5 years ago
13
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9

Lab Case 62

A 62 year old man presents to your ED by ambulance. He has had vomiting and diarrhoea for the last week and complains of abdominal pain. He is unable to keep anything down, has severe weakness with inability to stand.  
emergucate.com
almost 5 years ago
1
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11

Nasogastric Tubes

Ileus or intestinal obstruction can lead to the accumulation of gases and liquids in the gastrointestinal (GI) tract. Unless these are removed, vomiting may occur and a significant risk of aspiration is present.  
emergucate.com
almost 5 years ago
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24

Effect of administration of antihelminthic for soil-transmitted helminths during pregnancy | Cochrane

Intestinal worms (helminths) contribute to iron-deficiency anaemia as they feed on blood and cause further bleeding by releasing anticoagulant compounds. They also affect the supply of nutrients and cause anorexia, vomiting and diarrhoea. Pregnancy complicated by maternal hookworm infection poses a serious threat to the health of mothers and their babies, especially in developing countries. Women who are anaemic during pregnancy are more likely to have ill health, give birth prematurely, and have low birthweight babies with low iron reserves. Antihelminthic drugs are highly effective and have minimal side-effects but information on their use during pregnancy is limited. The major concern is that the drugs may cause malformation of the fetus (teratogenic effects). We examined the research published up to 31 January 2015 on the impact of giving a single antihelminthic treatment in the second trimester of pregnancy on maternal anaemia and pregnancy outcomes.  
cochrane.org
almost 5 years ago
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7

Post tonsillectomy hemorrhage

Tonsillectomy is one of the most common procedures performed in children. Post op hemorrhage is either primary (within 24 hours) or secondary/delayed ≥24 hours. Primary hemorrhage is more rare and is seen in 0.2-2% of cases. Secondary hemorrhage is a bit more common, especially in the Emergency Department as kids have been home for several days. rates vary, but estimates settle around 3%. It most commonly occurs between 5-10 days post-op, with the median 6th POD. The cause is separation of the eschar – which may be precipitated by dehydration, vomiting or rarely infection. Most stop on their own, but rarely they can lead to calamitous bleeding and airway compromise – so it is obviously a good idea to take them seriously.  
pemcincinnati.com
almost 5 years ago
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15

Intravenous infusion of lidocaine starting at the time of surgery for reduction of pain and improvement of recovery after surgery | Cochrane

The most common problems immediately following surgery are pain, nausea and vomiting, excessive blood clotting, slowing or stopping of the movement of food and fluid through the digestive system, and postoperative cognitive dysfunction. Fast-track protocols aim to prevent or reduce these complications and speed up early recovery. Opioid medications that are given to reduce the postoperative pain can be associated with side effects including nausea and constipation, which prevent a smooth recovery. Other options include the administration of epidural opioid medications (injected into the space surrounding the spinal cord). The pain can be a mixture of inflammatory and neuropathic pain or based on increased sensitivity to pain. All are helped by intravenous lidocaine, which is a non-opioid local pain medication or local anaesthetic.  
cochrane.org
almost 5 years ago
Www.bmj
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11

A cutaneous manifestation of intra-abdominal disease

A 49 year old man presented to the emergency department with acute onset pain in the right upper quadrant and epigastric pain radiating to his back. Over the past 24-36 hours he had experienced nausea and vomiting as well as dark urine and pale stools, and he had developed several painful lumps on his abdomen and upper limbs.  
feeds.bmj.com
almost 5 years ago
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31

Drug treatment of adults with nausea and vomiting in primary care

A usually healthy 25 year old man presents to you as his general practitioner at 9 am. He has had fluctuating nausea with four vomits and one loose stool overnight, associated with colicky central abdominal pain. No blood was present in the vomit or stool, and he reports that his girlfriend was recently diagnosed as having “viral gastro.” He is afebrile, intermittently uncomfortable, but otherwise well, with mild epigastric tenderness but no guarding or rebound. Clinically, you believe viral gastroenteritis is the most likely cause of his symptoms, and you consider his request for treatment that will help to stop his vomiting so that he can get to his evening shift at a factory.  
feeds.bmj.com
almost 5 years ago
Www.bmj
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16

An elderly woman with postprandial abdominal pain

An 84 year old woman presented with a five month history of central, recurrent, severe epigastric pain, which occurred about 20 minutes after eating. This was associated with nausea, occasional diarrhoea, and vomiting. She had experienced early satiety and weight loss over the last few months. Her medical history included myocardial infarction two years earlier. She also had a 40 pack year history of smoking. On examination, she was cachectic, but physical examination and digital rectal examination were otherwise unremarkable. Blood tests—including full blood count, liver functions tests, amylase, and renal function—were normal. Chest and abdominal radiographs, abdominal ultrasound, and computed tomography of the abdomen were unremarkable. Computed tomography angiography was performed (fig 1⇓).  
feeds.bmj.com
almost 5 years ago
Www.bmj
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19

A young woman presenting with severe headache

A 20 year old woman with a history of migraine with visual aura in the form of both positive (fortification spectrum) and negative features was admitted to hospital because of unilateral pulsatile right sided headache of one day’s duration. The headache was associated with photophobia, intense nausea and vomiting, right sided facial and upper arm numbness, and a right sided temporal visual field defect. She described the headache as similar to her habitual migraines in character but “the worst ever.” On examination she was normotensive and her Glasgow coma scale was 15. On neurological examination the visual field defect was confirmed and she reported reduction in light touch over the right side of her face and right upper limb.  
feeds.bmj.com
almost 5 years ago
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6

Dr. Smith's ECG Blog: Epigastric Abdominal Pain and Vomiting

Instructive ECGs in Clinical Context ----Archives, Popular Posts, and an Index of all ECGs are down the right-hand side.  
hqmeded-ecg.blogspot.com
almost 5 years ago
Pharm logo 1400x1400
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8

Geyser from Kaiser – Bringing vomiting simulation to you

Geyser from Kaiser from Rob Bryant on Vimeo.  
prehospitalmed.com
almost 5 years ago
2
4
111

Bilious Vomiting in the Neonate

(Disclaimer: The medical information contained herein is intended for physician medical licensing exam review purposes only, and are not intended for diagnos...  
youtube.com
almost 5 years ago
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7

Vomiting Machine Proves We Actually Aerosolize Norovirus to Help it Spread |

At North Carolina State University there's a lab that has a vomiting machine, but it wasn't built for grad students to amuse themselves. The device is inst  
medgadget.com
almost 5 years ago
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10

Imaging Case of the Week 167

The following abdominal x-ray is from a 30 year old with vomiting and epigastric pain. She has had a lap band inserted a few years ago. What radiological sign can be seen?  
emergucate.com
almost 5 years ago
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0

You want more SALAD? You cant handle the SALAD!

The following are FOAMEd video resources made by Dr Jim DuCanto, Dr Mike Steurwald and Dr Matt Andersen, demonstrating a novel vomiting simulator to practice advanced techniques on managing the soiled airway in an emergency. The so called SALAD simulator made its international debut at the SMACC Airway workshop in Chicago this year.  
prehospitalmed.com
over 4 years ago