Category Name: em@3am

em@3am

EM@3AM: Vaginal Bleeding

 A 22-year-old female presents with three days of vaginal bleeding. She has soaked through multiple pads and has passed clots. She endorses some lightheadedness but no syncope. Her last period was two weeks ago. She has no known past medical history, does not use hormonal contraception, and is sexu...

em@3am

EM@3AM: Pneumocephalus

A 58-year-old female presents with severe headache and nausea. Her symptoms started shortly after leaving the office of her pain management doctor, where she had an epidural steroid injection to alleviate her chronic back pain approximately 30 minutes before she arrived in the ED. The patient denies...

em@3am

EM@3AM: Cotton Fever

A 30-year-old male with history of IVDU presents with fever. He reports last drug use was one hour prior to arrival and admits to reusing the same cotton filter on multiple occasions. He denies recent cough, chest pain, shortness of breath, abdominal pain, nausea, vomiting, or diarrhea. VS include T...

em@3am

EM@3AM: Takotsubo Cardiomyopathy

A 67-year-old female with past medical history of hypertension presents with acute onset of chest pain without associated symptoms. She describes the pain as left-sided, non-radiating, and 9/10 in severity. On exam, vital signs are normal. She is clutching her chest and is in acute distress due to ...

em@3am

EM@3AM: Cardiac Transplant Complications

A 64-year-old male presents to the ED with shortness of breath and abdominal pain. He is hypotensive and hypoxic. He has a history of heart transplant in 2014 but has not followed up for several years.

em@3am

EM@3AM: Hyperthermia

A 34-year-old male is brought via EMS after collapsing during an outdoor adventure race. EMS reports the patient was conscious but altered, with slurred speech and confusion. Point of care glucose in the field was 102 mg/dL. Vital signs include BP 80/40 mm Hg, HR 154 bpm, T 41C rectal, RR 28 breath...

em@3am

EM@3AM: Oculomotor Nerve Palsy

A 50-year-old female with no past medical history presents to the ED with a diffuse, constant headache onset a few weeks. The patient describes droopiness of the left eye and double vision associated with specific directional movements of the eye. On exam, you note ptosis of the left eye with findin...

em@3am

EM@3AM: Liver Transplant Complications

A 32-year-old female with a history of hypertension and autoimmune hepatitis status post liver transplant 6 weeks prior on tacrolimus and mycophenolate presents to the ED with abdominal discomfort. For the past two days, she describes worsening pain and intermittent vomiting. She came today because ...