Approach to New Onset Ascites

Author: Daniel Morrad PGY-4 Case: A 27-year-old Spanish speaking female with no medical history presents with complaints of abdominal pain. She is approximately 3 months postpartum from a vaginal delivery complicated by oligohydramnios. For 2 weeks she has had fever and sweats that seem to come and go, and abdominal discomfort described as a generalized …

2022 ACEP Acute Heart Failure Syndrome (AHFS) Guideline Update

Author: Daniel Morrad, PGY-4 Patients who present to the emergency department (ED) with symptomatic AHFS are not only associated with high morbidity and mortality, but these cases alone account for over 650,000 visits to the ED in the United States annually. Over 80% of these patients will be admitted to the hospital with more than …

Yew Broke My Heart

Resident: Joshua Pettengill MD, PGY-1 Emergency Medicine Faculty: Alexis L Cates DO, Emergency Medicine / Medical Toxicology The case… A 20 year-old female with a complicated psychiatric history of anxiety, bipolar disorder, OCD, and self-injurious behavior presents to the emergency department with a friend after a reported suicide attempt. The patient discloses that she had …

Valproic Acid Accident

Author: Grei Shele, DO, Emergency Medicine Resident, PGY1 Faculty:  Alexis Cates, DO, Medical Toxicology/Emergency Medicine Attending The Case… A 51-year-old woman with a past medical history of bipolar affective disorder presents to the emergency department for evaluation after ingesting 120 tablets of valproic acid approximately 30 minutes prior to her arrival. Each tablet was 500 …