Background: Due to low cost, dependability, and familiarity, one-way alphanumeric paging continues to be a commonly used method of in-hospital communication. However, lack of urgency indicators has been cited as a key limitation. To address this issue, an Interdisciplinary Communication Improvement Taskforce (In-CITe) at an academic medical institution adopted a Priority Structured Paging (PSP) system [...]

Background: Lack of urgency indicators and receipt confirmation are two of several known alphanumeric paging limitations. To address absence of urgency indicators, a Priority Structured Paging (PSP) system that allowed nurses to communicate priority was adopted at an academic medical institution across multiple nursing units caring for a mixed patient type and acuity. Data recorded [...]

Background: Stroke is the leading cause of mortality worldwide. However, available treatment options are limited due to the narrow treatment time window and reperfusion injury after revascularization. New treatment modalities to overcome these challenges are in need. Chlorpromazine and promethazine (C+P) have been utilized for cerebral edema, central high fever with restlessness, and delirium [1, [...]

Case Presentation: 35-year-old Caucasian gentleman who was diagnosed with alpha-1 antitrypsin deficiency (PiZZ) 2 years ago. Two weeks prior to the hospitalization, he noticed skin nodules on both sides of the abdominal wall and in the upper thighs. He also noticed a lesion that looked like a boil on his right shin, started draining and [...]

Case Presentation: 11 y/o M presenting with 2 months of worsening headache and 2-3 days of rapidly progressive blurry vision. Patient initially presented to his school nurse after complaining in class of blurry vision. He was seen by a local optometrist and then transferred to the emergency department for further evaluation. Ophthalmologic evaluation in the [...]

Case Presentation: A 43-year-old man with ankylosing spondylitis (on adalimumab), presented with 2-days of fever, cough, diarrhea, and encephalopathy. He had no significant travel history. On exam, he was tachycardic (P = 120 bpm), febrile (temperature 103.0oF), tachypneic (RR = 30 bpm) and had left-sided crackles. Notable labs: WBC = 12.3 109/L, Na+ = 130 [...]

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 [...]

Case Presentation: A 51-year-old man with history of psoriasis presented to the emergency department for abdominal discomfort and distention for 2 weeks, associated with fever, weight loss, night sweats, non-productive cough, and shortness of breath. He previously lived in Mexico and was treated in the past for latent tuberculosis (TB) with 6 months of isoniazid. [...]

Case Presentation: A 50-year-old man with a past medical history notable for non-alcoholic fatty liver disease, peptic ulcer disease, gout, and depression presented to the emergency department with a 5-day history of constant, sharp, epigastric abdominal pain. Preceding these symptoms, he experienced an episode of severe nausea, non-bilious non-bloody vomiting, diarrhea, and chills after eating [...]

Case Presentation: A 56-year-old male presented to the emergency department with acute-onset severe hypotension, light headedness, rash, nausea, and vomiting. He progressed to develop widespread urticaria and facial flushing. He was previously in his normal state of health. He reported eating “meat and potatoes for dinner”. Social history was pertinent for frequent tick exposure as [...]