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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?

em@3am

EM@3AM: Gastroesophageal Varices

A 57-year-old male presents with hematemesis. He has a history of cirrhosis from alcohol abuse. He appears toxic and is rushed to the resuscitation bay.  Initial VS include T 37.2C, HR 122, BP 88/41, RR 24, SpO2 90% RA. What are your next steps, and what is the likely diagnosis?

em@3am

EM@3AM: Proximal Femur Fracture

A 77-year-old female presents with left proximal femur and hip pain after falling from a standing position. She tripped over a rug and landed on her left side. She denies LOC or other symptoms. Her left leg is shortened and externally rotated. Her pulses in the leg are normal, and she is able to move her foot and toes. What are your next steps, and what is the likely diagnosis?