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em@3am

EM@3AM: Bladder Rupture

A 30-year-old male presents to the ED via EMS with severe hip and groin pain after an accident. He denies loss of consciousness, is not on any blood thinners, and currently complains of pain in his hips/groin. Initial assessment on arrival includes vital signs BP 134/86, HR 94, RR 16, SpO2 98% on room air, and temperature 99.0F. He is speaking and mentating appropriately but in significant discomfort when you exam his pelvis. Blood is seen at the urethral meatus, and the pelvis is unstable. There is no obvious perineal ecchymosis at this time. The rest of the exam is unremarkable. What type of injury should be considered with blood at the urethral meatus and suspected pelvic fracture?

em@3am

EM@3AM: Finger Amputation

A 28-year-old male presents as a transfer from an urgent care with report of left-hand injury. He is a construction worker and was using a table saw when he injured his left hand. The amputated part is wrapped in a plastic bag. He is right-handed. He has extensive injuries to the left hand, including amputation. What’s the next step in your evaluation and treatment?