Category Name: em@3am

em@3am

EM@3AM: Metacarpal Base Fractures

A 22-year old male presents to the ED after landing on his right thumb while playing football with some friends. The pain and swelling became progressively worse as he notes pain with any movement of his thumb. He is right hand dominant. On exam, the right MCP joint is edematous with point tenderne...

em@3am

EM@3AM: Pyogenic Flexor Tenosynovitis

A 40-year-old female presents to your Emergency Department with three days of pain and swelling in her right index finger. On exam, her right index finger is diffusely swollen, erythematous, and held in flexion. There is a punctate wound on the dorsal finger distal to the  DIP. She has significant...

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...