Category Name: em@3am

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?

em@3am

EM@3AM: Ethylene Glycol Toxicity

A 37-year-old male presents with altered mental status. He has a history of recurrent alcohol intoxication, and his wife found him on the couch after he was working in the garage. She is concerned because he seems to be much more intoxicated than is usual. She also found spilled containers of antifreeze in the garage. What could be going on with this patient? Is he just intoxicated?

em@3am

EM@3AM: Diabetic Ketoacidosis

A 37-year-old female presents with dysuria, polyuria, polydipsia, and lightheadedness. She has a history of insulin-dependent diabetes but ran out of her glucose strips at home. She has had significant nausea and suprapubic pain. She is tachycardic and tachypneic. Exam reveals dry oral mucosa and suprapubic tenderness. POC glucose is 422 mg/dL. What is the diagnosis, and what are your next steps?

em@3am

EM@3AM: Esophageal Foreign Bodies

A 52-year-old male presents with inability to swallow. He was eating steak one hour ago and swallowed a large piece without chewing. He thinks it is stuck around his upper sternal area. Physical exam reveals a patient who appears uncomfortable, sitting upright, constantly spitting into a bag. You do not see anything in his mouth. What is the next step in your evaluation and treatment?

em@3am

EM@3AM: DVT

A 28-year-old female presents with right lower leg swelling and redness. She just returned from an overseas flight. She denies chest pain or shortness of breath. VS are normal, and her right lower leg is swollen, with diameter > 3 cm compared to her left. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Toxic Megacolon

A 28-year-old male presents with abdominal pain, diarrhea, distension, and fever. He has a history of ulcerative colitis. Vital signs include BP 97/58, HR 121, T 100.9 Oral, RR 24, SpO2 98% on RA. Exam reveals a patient who appears systemically ill, and his abdomen is diffusely tender. His bowel s...

em@3am

EM@3AM: Small Bowel Obstruction

A 63-year-old female presents with abdominal pain, decreased bowel movements, nausea, three episodes of vomiting, and abdominal distension. She has a history multiple abdominal surgeries. Exam shows abdominal distension and generalized tenderness, but no peritoneal signs. What are your next steps?

em@3am

EM@3AM: Acute COPD Exacerbation

A 58-year-old male presents with severe shortness of breath, productive cough, and decreased ability to ambulate at home. He has COPD and is on oxygen at home. Several days ago he noted worsening congestion, myalgias, and cough. He is now severely short of breath and unable to complete his activitie...