Sean Lowe

Administrative Fellow Emory University, Department of Emergency Medicine Attending Physician

Most commented posts

  1. Followup on Dr. Pendley’s Nailbed Post — 5 comments
  2. How not to get sued…and just good patient care! — 4 comments
  3. Radiation Risk — 3 comments
  4. Anaphylaxis — 3 comments
  5. EKG of the Day? — 3 comments

Author's posts

Ankle Fractures!

Case Presentation:  Hx:  57 yo M p/w fall from 10 feet complaining of L ankle pain PE:  Primary survey intact.  Secondary survey for apparent intoxication and ankle deformity.  EFAST negative.  CxR, Pelvis XR and PAN Scan negative. Ankle Fractures Learning Points: 1)      Anatomy:  The ankle joint is made up of the medial malleolus (distal tibia), …

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Pregnant with headache

Presentation:  37 yo F with progressive headache, R hand tingling, and incidentally found on this ER visit to be pregnant.  Top 5 Teaching Points Cerebral Vein Thrombosis (1):  1)      It’s rare:  about 1:100,000 in a year (but about 11:100,000 in pregnant women) 2)      Pt’s present with a progressively worsening localizing headache over days (as venous …

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RUQ Pain

Presentation:  46 yo M with 2 day hx of RUQ pain and n/v.  Taking Tylenol for pain.   PE:  VS NL, appears distressed, + TTP in RUQ and epigastrium Workup:  RUQ US:  showing sludge in gall bladder, no stones, no pericholecystic fluid and the wall was not thickened.  However, the common bile duct was dilated to 8mm …

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Epi-Pen to the finger!

Presentation:  48 to M accidentally injected Epipen into finger Physical Exam:  Pale painful finger with decreased sensation. Management:  Nitroglycerin ointment to finger and 1.5mg Phentolamine mixed with 1cc 2% lidocaine and inject into the finger. Outcome:  Patient was discharged with close hand followup.


Case:  5 yo F with sudden onset of R sided neck pain, no PMHx Presentation:  VS NL, no report of trauma, well appearing child crying, head twisted with chin pointing toward L shoulder Diagnosis:  Torticollis.  Spasm of the sternocleidmastoid common in children.  On the differential is retropharyngeal abscess in patients with sore throat and fever …

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Radiation Risk

Radiation Risk: Average US background radiation in one year:  3 mSv CxR:  0.02 mSv  Pelvis XR: 0.7 mSv  CT Head: 2mSv CT Chest:  8mSv CT A/P: 10mSv  Cardiac PET: 14mSv So what is the risk for cancer?  It varies by study type, age, and sex.  So for example, if a 20 yo F gets a …

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Ear Lacerations

Ear Lacerations: Pt. with a laceration through the helix of the ear with exposed cartilage 2 Point Ear Block:  Am Fam Physician. 2004 Feb 1;69(3):585-590. Goal:  Approximate cartilage with absorbable 5-0 monocryl.  It’s ok to trim away small amount of jagged or devitalized skin or cartilage to ensure proper approximation.  Close the skin over the cartilage with 5 …

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Anal Fissures!

Exciting topic:  Anal Fissures! Definition:  Tear in the anorectal dermal tissue, usually at the posterior “6 o’clock” position where the anorectal muscle come together Hx:  Patient presents with sudden onset rectal pain with small amount of bleeding PE:  Usually posterior tears, but if tear occurs at any other position consider comorbid conditions such as IBD …

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Hypertension and Pregnancy

Got a hypertensive pregnant patient?  Preelampsia:  Hypertension >140/90 with proteinuria >300mg/24hours Eclampsia:  Addition of SZ activitity, signs of end organ involvement (i.e. visual complaints and headache, creatinine elevation) Watch out for HELLP!  Hemolysis, elevated liver enzyme, low platelets Treatment:  Expectant management, delivery if possible, treat seizures with Magnesium Dose:  6g loading followed by 2g/hour Learning point …

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Pearles and Pitfalls of IVDA

This case Courtesy of David Zhou and Patrick Meloy:   EMory Files Case #7:  Deltoid Abscess Hx: 37 yo female with a hx of IV heroin abuse (IVDA) who presents with bilateral shoulder pain. She has been injecting heroin using the skin popping method PE: Temp: 37.3 °C, Heart Rate: 60, RR: 17, BP: 122/58 …

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