Category Name: em@3am

em@3am

EM@3AM: Open Fracture

A 22-year-old male is brought in by EMS to the ED after falling 20 feet. He landed primarily on his right leg, which is now obviously deformed with broken skin and exposed bone distally. He is in obvious pain with a grossly deformed right ankle. Pulses are normal and equal bilaterally. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Kidney Transplant Complications

A 65-year-old with a history of ESRD and renal transplant presents to the ED with lower abdominal pain and fevers. On exam, his vitals include HR 112, BP 101/62, RR 22, T 101.1, SpO2 98% on RA. His is tachycardic with lower extremity edema and lower abdominal tenderness to palpation. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Viscous Perforation

A 57-year-old male presents with progressively worsening epigastric pain.  Shortly after dinner he felt a sharp pain in his epigastric region. He is tachycardic and tachypneic and appears in distress with diaphoresis. Abdominal exam shows diffuse tenderness with guarding. What should you consider?

em@3am

EM@3AM: Back Pain

A 59-year-old man presents to the ED for acute onset low back pain that started immediately after he moved furniture. He states his lumbar pain has been unrelenting, with mild pain radiating to down both legs.  He appears in pain and has mild midline and bilateral paraspinal tenderness to palpation...

em@3am

EM@3AM: Overdose

A 38-year-old male presents from triage in a hospital wheelchair with his head slumped to one side. You immediately move him into bed and assess his ABCs. He wakes briefly, but he seems to be hallucinating. Vital signs: BP 154/110, HR 110, T 102.1, RR 20, SpO2 100% on room air. Physical exam reveals...

em@3am

EM@3AM: Urolithiasis

A 34-year-old male presents with intermittent, sharp, left-sided flank pain. He took ibuprofen with minimal relief, but came to the ED when he noticed blood-tinged urine. He has also experienced severe nausea without emesis. He appears uncomfortable, writhing in bed. What is the patient’s diagnosis? What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Placental Abruption

A 31-year-old G3P2 female at 32 weeks gestation is brought in by EMS after a fall with complaint of lower abdominal pain. Exam reveals gravid abdomen with lower abdominal tenderness and no signs of bruising. External pelvic exam shows no signs of trauma, but there is scant blood at the introitus. Fe...

em@3am

EM@3AM: Mastoiditis

A 2-year-old male is brought to the ED by his mom for right ear pain and high fevers. His right ear is notably pushed forward. On exam, he is alert but fussy, with auricular proptosis and mastoid redness. What’s the next step in your evaluation and treatment?