Category Name: em@3am

em@3am

EM@3AM: Penile Fracture

A 32-year-old male presents to the ED with penile pain. He states he was having sexual intercourse when he heard a loud pop, followed by sharp pain and immediate loss of erection. His vitals are HR 107, BP 128/46, RR 19, and T 37.2C. What is your diagnosis, and what diagnostic study would you order if there was blood at the meatus?

em@3am

EM@3AM: Laryngospasm

An 8-year-old male presents after falling onto an outstretched hand. He has an obvious dinner fork deformity to the right forearm. X-ray confirms a fracture of the distal radius and ulna. You prepare for procedural sedation with ketamine while you reduce and splint the fracture. You run through the ...

em@3am

EM@3AM: Nephrotic Syndrome

A 25-year-old female with no significant past medical history presents with progressive periorbital and lower extremity edema for one week. She denies recent fever, chest pain, shortness of breath, allergies, or recent travel. Vitals include BP 120/90, HR 90, RR 18, Temp 98.7F. Exam shows a developm...

em@3am

EM@3AM: Beverage Tab Ingestion

A 12-year-old boy with no past medical history accidentally ingested a soda can tab 2.5 hours prior to arrival. He is asymptomatic at present, feels well, and is able to tolerate secretions without difficulty. On exam, the patient is alert, acyanotic, and non-stridulous. Breath sounds are clear to a...

em@3am

EM@3AM: Peritoneal Dialysis Emergencies

A 42 year-old male presents with abdominal pain and fevers for 72 hours, with nausea and vomiting for 24 hours. He has a history of ESRD and has been on peritoneal dialysis for 5 years. Triage vital signs (VS): BP 105/60, HR 121, T 101.4 temporal, RR 24, SpO2 98% on room air. Pertinent physical exa...

em@3am

EM@3AM: Proctitis

A 42-year-old male undergoing recent radiation therapy for colorectal cancer presents with pelvic and anal pain and pain with defecation. He experiences extreme pain prior to and during defecation. He has had mucous and blood in his stool. He denies a history of hemorrhoids. Pertinent physical exami...

em@3am

EM@3AM: Atrial Flutter

A 70-year-old male with diabetes, coronary artery disease, and one-vessel CABG presents with palpitations and angina for one day. He is in no acute distress. His vital signs include BP 148/96, HR 150, RR 18, SpO2 96%, and T 37.2C. His EKG reveals atrial flutter.

em@3am

EM@3AM: Acute Respiratory Distress Syndrome

A 66-year-old male presents via EMS in respiratory distress. For the past several days he has had worsening productive cough, chest pain, dyspnea, and fever. He appears fatigued, is sitting up in bed, and has increased work of breathing. On exam there is no JVD, 1+ edema, and crackles bilaterally. V...