A 30-year-old male presents after a motor vehicle accident with chest pain and shortness of breath. He is alert, speaking in 1-2 word responses, and appears in moderate respiratory distress. He has normal left sided breath sounds, but none on the right. No lung sliding is seen with ultrasound examin...

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, erythematou...

A 42-year-old male presents with headache, fever, chills, nausea, and myalgias. He returned from a month-long trip to Africa several weeks ago. On examination, he is tachycardic and febrile. You do not find a rash or meningismus, but you palpate an enlarged spleen and liver.  What is your next step in evaluation and management?

A 39-year-old female presents with severe epigastric pain, nausea, and several episodes of non-bloody, non-bilious emesis. The pain is sharp and radiates to her back. On examination, she is tachycardic and tachypneic with diffuse abdominal tenderness, but afebrile. Her lipase returns at 1100 U/L. What is your next step in evaluation and management?

A 10-day-old female presents with her parents with poor feeding and increased work of breathing. Her urine output has been poor, but her parents have not observed fevers. She is afebrile, but her HR is 188, RR is 61, and oxygen saturation is 94% on room air. She demonstrates increased work of breath...

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?

A 65-year-old with a history of ESRD and renal transplant presents to the ED with lower abdominal pain and fevers. On exam, his vitals include HR 112, BP 101/62, RR 22, T 101.1, SpO2 98% on RA. His is tachycardic with lower extremity edema and lower abdominal tenderness to palpation. What’s the next step in your evaluation and treatment?

A 57-year-old male presents with progressively worsening epigastric pain.  Shortly after dinner he felt a sharp pain in his epigastric region. He is tachycardic and tachypneic and appears in distress with diaphoresis. Abdominal exam shows diffuse tenderness with guarding. What should you consider?