A 21 year-old male presents to your ED with complaints of fever, rash, and generalized malaise. His triage vitals are HR 112, BP 95/55, RR 22, POx 98%, T 102.3F. When you go into the room to exam him, you notice a tampon in his right naris. When you ask Read more…
A previously healthy 3 year-old boy was brought in by his mom who reported pink urine after visiting his grandmother over the Christmas break. Review of systems is otherwise negative. The patient has no medical history and does not take any medications. He is well-appearing and afebrile. The physical exam is Read more…
A few months back, I wrote about the lack of accuracy in using peripheral venous blood gas to estimate the CO2 of an arterial sample, particularly when the levels are very high1. My continued review of the subject supports the unreliability of such interpretation of peripheral venous values alone. Dr. Rees, a researcher who Read more…
New year, new beginnings, and new resolve. A 31 year-old slightly overweight male visits the emergency department a week after New Years with a chief complaint of muscle soreness. He had recently attended a soulcycle session with his girlfriend as part of his new year’s resolution to lose some of his winter weight. The next day he was extremely sore (more than expected) and started to have dark urine (not expected). Our enthusiastic exerciser has rhabdomyolysis.
Patellar Dislocation By: Juliana Jaramillo, MD PGY2 Case: 24 year-old female presents with right knee pain after slipping on ice. Her right leg got caught and twisted, and she felt as if something came out of place. She is unable to extend at the knee. Upon evaluation of patient you Read more…
It’s Christmas Eve, and you walk in to the ED wishing for a silent night. You get settled in, and you see “Clause, Santa- 1746 yo M wrist pain” show up on your board. Apparently, Rudolph found his way into the spiked eggnog, and Santa had some difficulty getting Read more…
Endophthalmitis Definition: Inflammation, usually from an infection, within the anterior and posterior segments of the eye.4 Symptoms/Signs:2,5 Symptoms include blurry vision (93%), eye pain (75%), lid swelling (33%), and conjunctival injection (81%) **Typically there is no fever or leukocytosis for Endophthalmitis alone** Anterior Segment: Inflammation of aqueous humor. Look for Read more…
You’re working a peds shift when a concerned pair of parents brings their three year old child in with a swollen, red, warm bump on his forearm. They first noticed it yesterday, and it has progressively gotten larger. He’s not irritable, but his arm seems to be bothering him. You Read more…
A 55 year-old morbidly obese female was brought in by EMS after a mechanical fall at home. She sustained the above distal tib-fib fracture while attempting to stand up. No LOC reported, and she is not taking any blood thinners or antiplatelet agents. On Arrival, BP 160/90, HR: 110 regular, Read more…
A 52-year-old man with diabetes, hypertension, end-stage renal disease on dialysis, and CAD presents to the ED with sudden onset of shortness of breath. He endorses missing his last dialysis session because he left the country for a week and was forced to pay for his last session out-of-pocket in Read more…