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em@3am

EM@3AM: Extensor Tendon Laceration

A 35-year-old right handed male with no significant past medical history presents with a deep hand laceration. The patient states they suffered a cut with a box cutter at a construction site. He presents to the ED with profound difficulty extending his middle and ring finger and a laceration over the extensor surface. What is the diagnosis?

em@3am

EM@3AM: Flexor Tendon Laceration

A 41-year-old male with no significant past medical history presents with a deep hand laceration. The patient states they were cutting an avocado when the knife pierced through and punctured his hand. He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger.

em@3am

EM@3AM: Sacral fractures

A 75-year-old male with a history of hypertension, osteoarthritis, and diabetes mellitus presents to the ED with a chief complaint of lower back pain.  He states that he fell a few days ago and the pain is getting worse, particularly when he is sitting down. His vitals include blood pressure 150/95, heart rate 95, SPO2 99%, temperature 36.6C, and a glucose of 143. On examination, the pelvis is stable, but he endorses tenderness midline along his sacrum. He has a normal neurologic exam in all extremities. What’s the diagnosis?

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?