REBEL Core Cast – Basics of EM – Weakness

Take Home Points

  • Be prepared to do everything with these cases, if they can’t provide information, dive into their medication list, history, contact whoever you have to to get more information
  • Keep differentials wide – then approach these cases with the mindset of focal vs generalized weakness and work from there
  • Focal – ask about muscle weakness, bowel and bladder incontinence, perform a complete neuro exam – finger to nose, heel to shin, ambulation, and perform an NIH stroke score
  • Generalized – think about cardiac, metabolic, and endocrine causes like myxedema coma, order ALL the tests including a head CT if their baseline is not known
  • Don’t forget the toxicology component – is this a medication side effect? Check their medication list!
  • Look for objective signs pointing to badness – bladder retention, diaphoresis, decubitus ulcers, pallor, dark stools, purulent urine – they can all help narrow down the list of differentials

REBEL Core Cast – Basics of EM – Weakness

Click here for Direct Download of the Podcast

Co-Host

Jenny Beck-Esmay, MD FACEP
Associate Professor for Emergency Medicine Icahn School of Medicine at Mount Sinai
Assistant Residency Director
Mount Sinai Morningside – Mount Sinai West
New York, NY
Twitter: @jbeckesmay

Post Peer Reviewed By: Anand Swaminathan, MD (Twitter: @EMSwami)

Cite this article as: Ellsworth Wright, "REBEL Core Cast – Basics of EM – Weakness", REBEL EM blog, June 1, 2022. Available at: https://rebelem.com/rebel-core-cast-basics-of-em-weakness/.

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