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Steven Wright

EM@3AM: Pediatric Aural Foreign Bodies

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A 6-year-old boy with past medical history of ADHD is brought in by his parents with left sided ear pain and irritability for 12 hours. He was at his normal state of health prior to this and has been afebrile. Parents deny any history of frequent ear infections or tympanostomy tubes, and he is up to date on his vaccinations. Otoscopic exam shows a smooth round green object in the right auditory canal. The tympanic membrane is not visualized.

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EM@3AM: Total Hip Arthroplasty Complications

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A 75-year-old female with past medical history of osteoporosis and total hip arthroplasty (3 months prior) presents with acute left hip pain after ground level fall. Initial vital signs include T 36.8, HR of 91, BP 138/88, RR 16, SPO2 98% on RA. On exam she is found in moderate distress lying supine and still on the gurney. Left lower extremity (LLE) is shortened, adducted, and internally rotated. 2+ dorsalis pedis and posterior tibial pulses are palpable, and sensation is intact to light touch distally. The patient is able to plantarflex and dorsiflex the foot/toes but motor exam is otherwise limited due to pain.

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