Background: “Time is brain” is a trope from the neurologist Camilo Gomez that emphasizes the importance of early treatment to improve the neurological prognosis of ischemic stroke patients. Given the short therapeutic window of evidence-based therapies such as thrombolysis and endovascular treatment, it is important to diagnose ischemic stroke from the numerous possible diagnoses accurately [...]

Background: Acute otitis media (AOM) is a commonly overtreated pediatric diagnosis. Since 2014, the American Academy of Pediatrics (AAP) has recommended a ‘wait-and-see’ strategy and shorter antibiotic courses for mild or moderate AOM in qualifying patients. While this strategy has been successfully implemented in some pediatric emergency units (EUs), studies have shown that 30-90% of [...]

Background: Delays in antibiotic administration in sepsis – particularly after the development of hypotension – are associated with increased mortality. Current guidelines recommend antibiotic initiation within one hour of sepsis recognition. However, it is not known how timing of hypotension relates to the timing of meeting sepsis diagnostic criteria and the initiation of treatment. We [...]

Background: Hospitalized patients often require post-acute care (PAC) after discharge ranging from long-term acute care hospitals (LTACH) to home health services. However, patients waiting for discharge to PAC are at risk for delayed discharges [1], which can increase in-hospital complications, increase costs, and decrease access to hospital care for other patients. [2, 3] Disposition prediction [...]

Case Presentation: A 48-year-old female presented with a 1-day history of exertional, non-positional, mid-sternal, severe chest pain associated with nausea, palpitations and dyspnea. She denied orthopnea, ankle swelling, cough, wheeze, coryza, fever, chills, or recent ill contacts. Past medical history: asthma, vertebral artery dissection, hypothyroidism, migraines, and severe acute respiratory syndrome coronavirus 2 (COVID-19) infection [...]

Case Presentation: A 29-year-old man with a history of morbid obesity, asthma, and chronic tracheostomy presented with 3 weeks of abdominal pain. The pain was intermittent and epigastric, without relationship to eating. He had poor appetite and nausea, though no emesis. He denied use of ibuprofen or alcohol. He denied fevers or chills. The pain [...]

Case Presentation: A 57 year old man with no significant medical or psychiatric history was admitted to our hospital after a suicide attempt. He was found unconscious in his car with the ignition running in a closed garage. His carboxyhemoglobin level was elevated at 13%. He regained consciousness within a few hours without requiring intubation [...]

Case Presentation: 76 year old male with non-Hodgkin lymphoma presented with shortness of breath and cough and was admitted with acute hypoxic respiratory failure (AHRF). Last chemotherapy treatment was one month before presentation with rituximab, in addition to other agents. He had completed 2 out of 6 planned chemotherapy cycles. On physical exam, there were [...]

Case Presentation: Case Presentation: This is a 3 year old male who recently returned from two months traveling in Liberia. In Liberia, he contracted malaria and was treated with two days of IV antimalarial treatment (thought to be artesunate) followed by three days of oral artemether-lumefantrine with improvement in symptoms. Ten days after completing treatment, [...]

Case Presentation: An 84 yo female with a past medical history of HTN, HLD, GERD and reactive airway disease presented with acute shortness of breath and wheezing. Patient appeared anxious, with cyanotic lips and labored breathing. O2 sat on RA was 78%. Associated symptoms included vomiting, diarrhea and an urticarial rash. Patient was successfully treated for [...]