Ryan Sumpter

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 tenderness over the lateral aspect of his knee joint. Ligament and meniscal evaluation cannot be completed due to pain on knee exam. There are no signs of neurovascular compromise on exam. What’s the next step in your evaluation and treatment?

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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?

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EM@3AM: Peritonsillar Abscess

A 15-year-old male presents to the pediatric ED for worsening sore throat and fevers for 5 days. He complains of right sided throat pain, odynophagia, and a muffled voice. He is tachycardic, febrile, uncomfortable appearing, and sitting upright.  You note trismus, swollen right tonsil, erythematous and elevated soft palate, and uvula deviated towards the left tonsil. What’s the next step in your evaluation and treatment?

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EM@3AM: Open Fracture

A 22-year-old male is brought in by EMS to the ED after falling 20 feet. He landed primarily on his right leg, which is now obviously deformed with broken skin and exposed bone distally. He is in obvious pain with a grossly deformed right ankle. Pulses are normal and equal bilaterally. What’s the next step in your evaluation and treatment?

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