Category Name: em@3am

em@3am

EM@3AM: Elbow Dislocation

A 15-year-old male with no past medical history comes in complaining of left arm pain. The patient was brought to the emergency department by his mother just after he fell while playing football. The patient is noted to have his arm held at 45-degree flexion. There is significant swelling over dista...

em@3am

EM@3AM: Transfusion Related Acute Lung Injury

A 67-year-old female with a history of ALL comes into the ED for weakness, stating her oncologist sent her for her semi-regular transfusion. From review of the EMR, her hemoglobin in 5.9 mg/dL and her platelet count was 1,000 cells/uL. A transfusion of platelets was initiated, though within approxim...

em@3am

EM@3AM: Transfusion Associated Circulatory Overload

A 67-year-old female with a history of CHF and CKD was brought in by ambulance from her nursing home for a gastrointestinal bleed. The patient’s total fluid balance from her nursing home was 2.5L over the past 24 hours. Her point of care hemoglobin is 4 g/dL and a transfusion of 2U pRBC and 1 FFP ...

em@3am

EM@3AM: Hypothermia

A 37-year-old female with history of alcohol and drug abuse is brought in after being found asleep on a bench on a cold winter morning. She is unresponsive. Vital signs are notable for HR 45, BP 85/40, SaO2 90%, rectal temperature 29C. Naloxone is given with no improvement, and the patient is intuba...

em@3am

EM@3AM: Polycythemia

A 63-year-old male without any past medical history presents to the emergency department with several weeks of headaches, some blurry vision while walking at a quick pace, and shortness of breath. His last checkup with his primary doctor was about 3 years ago and everything was ‘normal’. He take...

em@3am

EM@3AM: Methemoglobinemia

A 42-year-old female with a past medical history of iron deficiency anemia presents to the ED with a peritonsillar abscess. You give 2 benzocaine sprays and successfully aspirate the abscess. As she is waiting for her discharge paperwork, the nurse alerts you that her oxygen saturation is now in the...

em@3am

EM@3AM: Pink Baby

A 3-month-old male is brought in for increased work of breathing for the last 4 days. The patient has had no fevers or sick contacts. He was born full term without complications, is fully vaccinated, and has no familial medical history. Triage vital signs (VS): BP 85/50, HR 152, RR 56, SpO2 92% on r...

em@3am

EM@3AM: Grey Baby

A 3-day full term male presents with poor feeding and lethargy, looking grey. He is diaphoretic with feeds. He has not gained weight since birth. He is afebrile, tachycardic, tachypneic, grey appearing, with cool extremities and poor capillary refill. What should you consider?