Introduction: An attempt at medical management is often the initial step in addressing esophageal obstruction from an impacted food bolus. Medical management, however, has limited success and often requires urgent endoscopy. We present a case in which standard medical treatment failed, but a swallowing augmentation maneuver resolved the obstruction. 

Case Report: A 67-year-old female presented with esophageal obstruction after eating steak. Transfer to higher level of care for endoscopy was initiated; however, the receiving gastroenterologist suggested an “upright posture, chin tuck, double swallow” maneuver. This immediately resolved the patient’s symptoms, and she was discharged home. 

Conclusion: This case suggests a novel, non-endoscopic technique for esophageal obstruction from food bolus impaction. 

Case Presentation: An 88-year-old female presented to the emergency department (ED) with complaints of painful vision loss four days after an intravitreal injection for her neovascular macular degeneration. Her right eye visual acuity was markedly diminished with an absence of red reflex. A point-of-care ocular ultrasound was performed and demonstrated hyperechoic vitreous debris concerning for endophthalmitis.

Discussion: Endophthalmitis is an infection of the vitreous or aqueous humors commonly caused by exogenous sources, such as inoculation of bacteria into the eye from surgery, injections, or trauma. It is an ophthalmologic emergency as it is a vision-threatening infection. Although a rare complication, post-surgery or post-injection are the leading causes of endophthalmitis. Point-of-care ocular ultrasound findings suggestive of endophthalmitis, such as hyperechoic vitreous debris, aid in the timely diagnosis and treatment of patients in the ED.

Case Presentation: A 64-year-old man presented to the emergency department with a chief complaint of left shoulder pain after a mechanical fall from standing. Plain radiography revealed a displaced fracture of the inferior glenoid rim. A computed tomography further characterized the fracture and the patient was taken emergently by an orthopedic surgeon for open reduction and internal fixation.

Discussion: Scapula fractures, especially isolated glenoid rim fractures, are rare and most typical of high-energy mechanism traumas. A missed or delayed diagnosis can result in long-term suffering and disability. Awareness of radiographic as well as physical findings and the subsequent classification system described below can optimize outcomes for trauma patients with glenoid fractures.

Introduction: In this study we aimed to investigate the effects of incorporating Swedish-style fika (coffee) breaks into the didactic schedule of emergency medicine residents on their sleepiness levels during didactic sessions. Fika is a Swedish tradition that involves a deliberate decision to take a break during the workday and usually involves pastries and coffee. We used the Karolinska Sleepiness Scale to assess changes in sleepiness levels before and after the implementation of fika breaks.

Methods: The study design involved a randomized crossover trial approach, with data collected from emergency medicine residents over a specific period. This approach was done to minimize confounding and to be statistically efficient.

Results: Results revealed the average sleepiness scale was 4.6 and 5.5 on fika and control days, respectively (P = 0.004).

Conclusion: Integration of fika breaks positively influenced sleepiness levels, thus potentially enhancing the educational experience during residency didactics.