Category Name: em@3am

em@3am

EM@3AM: Cyanide Toxicity

A 13-year-old male is brought in by EMS for altered mental status after being found in a house fire. The fire department found burned couches in the house with melted plastic covering. His vital signs include BP 78/40, HR 155, T 99.9 Oral, RR 40, SpO2 92% on 15L NRB. He is somnolent but withdraws to...

em@3am

EM@3AM: Posterior Shoulder Dislocation

A 28-year-old male presents to the ED with right shoulder pain after falling on an outstretched arm two hours earlier. He denies history of prior shoulder injuries. On exam, he is holding his right upper extremity in adduction and internal rotation at the shoulder. He is unable to externally rotate ...

em@3am

EM@3AM: Salicylate Overdose

A 22-year-old female presents to the ED after taking an entire bottle of unknown medication approximately an hour and a half ago. She describes a ringing sensation in her ears and mild nausea with no vomiting. Triage vital signs (VS): BP 122/75, HR 115, T 99.8 Oral, RR 32, SpO2 99% on RA. She is t...

em@3am

EM@3AM: Osteomyelitis

A 51-year-old male with diabetes mellitus presents with pain in his left foot, as well as fever and chills. His physical exam is notable for a 3 cm ulcer over the plantar aspect of his left first MTP joint, with surrounding warmth and erythema. Using a sterile instrument, bone was easily probed. What is your next step in evaluation and treatment?

em@3am

EM@3AM: Encephalitis

An 18-year-old female presents with confusion, seizures, and fever. Patient is unable to provide history, but her mother states that she began noticing confusion 2 days ago, and the patient expressed head discomfort yesterday. The patient appears lethargic and does not follow commands, and she is fe...

em@3am

EM@3AM: Tibial Plateau Fracture

40-year-old male is brought by EMS after being struck on his left side while crossing the street by a vehicle at 20 mph. He is visibly uncomfortable, laying on his right side, and refusing to move his left leg. His left lower extremity has an obvious effusion along with localized swelling and tender...

em@3am

EM@3AM: Acute Necrotizing Ulcerative Gingivitis

A 45-year-old male presents to the ED for worsening, severe oral pain and acute bleeding of his gums. He has HIV and is non-compliant on HAART. You note halitosis, gingival bleeding, increased mobility of the front lower teeth, ulcerated “punched out” lesions along the interdental papillae, and anterior cervical lymphadenopathy. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Anterior Shoulder Dislocation

A 35-year-old male presents with right shoulder pain. He was playing football with some friends, and as he was in the midst of throwing the football, a friend hit his throwing arm. He is holding his arm in an internally rotated and abducted position. You are able to detect an ulnar and radial pulse ...