Case of the Month 2026
Case of the Month: June 2026
Jan and Swami dive into a challenging emergency department case involving an agitated, altered patient with an unclear diagnosis. What starts as a seemingly routine overdose presentation quickly turns into a high-stakes discussion on trauma evaluation, sedation strategies, airway decisions, and the real-world challenges of getting critical imaging in combative patients. Along the way, they explore practical approaches, clinical judgment calls, and emerging ideas that could one day change how emergency clinicians assess head injuries, all while sharing the kind of candid stories and insights that make emergency medicine both unpredictable and unforgettable.
Case of the Month: May 2026
A critically ill patient arrives in severe respiratory distress, barely able to speak and rapidly decompensating, demanding immediate recognition and action. Jan and Swami dive into the high-pressure decision-making that follows, focusing on how experienced clinicians prioritize interventions, choose the right tools in the moment, and aren’t afraid to be aggressive when it counts.
Case of the Month: April 2026
This week on EM:RAP, Swami and Jan dive into a complex case involving a frail 93-year-old patient with a suspected upper GI bleed and profound hypotension.
Case of the Month: March 2026
Swami and Jan dive into a high-yield emergency medicine case: a 30-something man in cardiac arrest after collapsing at a concert. In a fast-paced, practical discussion, they walk through key resuscitation decisions: managing a supraglottic airway, considering naloxone in undifferentiated arrest, using ultrasound to identify occult ventricular fibrillation, debating whether to shock a flat rhythm, addressing wide-complex rhythms empirically, and deciding on post-ROSC imaging. Packed with nuanced clinical reasoning and real-world pearls, this episode highlights the art behind cardiac arrest management and the critical thinking that goes beyond the algorithm.
Case of the Month: February 2026
In this EM:RAP Case of the Month, Jan and Swami kick off Groundhog Day by diving into a deceptively common ED presentation: cough and syncope. A 46-year-old woman with URI symptoms and post-tussive syncopal episodes prompts a thoughtful walk-through of syncope risk stratification, differential diagnosis, and standard workup, until an unexpected chest x-ray reveals a massive hiatal hernia. What follows is a fascinating diagnostic pivot, highlighting a rare but high-stakes cause of syncope due to extrinsic cardiac compression, confirmed on CT and echo and ultimately requiring urgent surgical repair. This case is a powerful reminder to stay curious, respect the basics, and recognize when an “incidental” finding can dramatically change management.
Case of the Month: January 2026
Swami and Jan kick off 2026 with a deep dive into a classic emergency medicine challenge: evaluating a patient with sudden chest pain and deciding whether aortic dissection is truly on the table. From clinical gestalt to the nuances of the Aortic Dissection Detection Risk Score, they walk through the real-time decision making, pitfalls, and practical considerations that shape this high-stakes diagnosis. Along the way, they unpack imaging choices, the role of D-dimer, when to act fast, and how to keep your threshold sharp without over-testing. It’s a thoughtful, case-based look at risk, uncertainty, and what it takes to get it right in the ED.