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em@3am

EM@3AM: High-Pressure Injection Injury

A 43-year-old male right hand dominant man presents with pain and swelling of his left index finger. He is a professional painter and was using an industrial pain sprayer when he injected his left index finger. It now is exquisitely painful, with a large degree of swelling. What’s the diagnosis, and what’s your next step in your evaluation and treatment?

em@3am

EM@3AM: Intussusception

A 3-year-old male presents with his mom with chief complaint of vomiting and recurrent abdominal pain. Her son will intermittently cry and refuse to eat, followed by normal activity. His appetite has been decreased. VS are normal. Physical exam reveals a patient who appears stated age, nontoxic, and playful. Your physical exam, including abdomen and GU, is normal. The mom rushes out several minutes later and notifies you that her son is crying and holding his abdomen. What’s the diagnosis, and what’s your next step in your evaluation and treatment?

em@3am

EM@3AM: 5th Metatarsal Fractures

A 23-year-old female presents with left foot pain after rolling her ankle in volleyball. She has some minor ankle pain, but her lateral foot is painful to touch or with weightbearing. On exam, the base of her 5th metatarsal is tender to palpation, with swelling and ecchymosis. What are your next steps, and what is the likely diagnosis?

em@3am

EM@3AM: Hernia

A 61-year-old male presents with lower abdominal pain on the right side. He says “I’ve had this bulge in my groin on the right for two days”. You find a small bulge in the right groin, but with no redness or discoloration of the skin. Palpation reveals mild tenderness over the site. What’s the next step in your evaluation and treatment?