Category Name: em@3am

em@3am

EM@3AM: Sialadenitis

A 70-year-old female with past medical history diabetes mellitus, hypertension, hyperlipidemia, dementia presents from nursing home with acute unilateral swelling along the left side of her face. She is breathing comfortably but seems to experience significant pain at the associated site of swelling...

em@3am

EM@3AM: Brainstem Strokes

A 74-year-old female presents to the ED via EMS for altered mental status and episodes of apnea. Vital signs include BP 168/89, HR 96, T 98.3, RR 3, SpO2 95% on 15L non-rebreather mask. Symptoms started acutely about 15 minutes prior to arrival. On exam, the patient opens eyes to voice, has extraocu...

em@3am

EM@3AM: Malignant/Necrotizing Otitis Externa

A 68-year-old male with a history of poorly controlled diabetes presents to the ED with increasing right-sided ear and facial pain, swelling, and difficulty hearing for two weeks.  He says the pain is worse at night and when he is chewing. Today, he noticed his right face looked swollen and he had ...

em@3am

EM@3AM: Auricular Hematoma

A 24-year-old male presents to the ED from a mixed marital arts competition after being struck on the side of the right head by a fist earlier today. The patient denies any loss of consciousness, neck pain, vomiting, or use of blood thinners. His vital signs include BP 133/82, HR 76, T 97.5, RR 15, ...

em@3am

EM@3AM: Thoracic and Lumbar Spine Trauma

A 70-year-old female with a past medical history of osteoporosis, atrial fibrillation, and hypertension presents with acute thoraco-lumbar back pain after a ground-level fall. She is stable, but she does have pain at the T-12/L-1 region of her back.  She has full motor strength and sensory function...

em@3am

EM@3AM: Vaginal Bleeding

 A 22-year-old female presents with three days of vaginal bleeding. She has soaked through multiple pads and has passed clots. She endorses some lightheadedness but no syncope. Her last period was two weeks ago. She has no known past medical history, does not use hormonal contraception, and is sexu...

em@3am

EM@3AM: Pneumocephalus

A 58-year-old female presents with severe headache and nausea. Her symptoms started shortly after leaving the office of her pain management doctor, where she had an epidural steroid injection to alleviate her chronic back pain approximately 30 minutes before she arrived in the ED. The patient denies...

em@3am

EM@3AM: Cotton Fever

A 30-year-old male with history of IVDU presents with fever. He reports last drug use was one hour prior to arrival and admits to reusing the same cotton filter on multiple occasions. He denies recent cough, chest pain, shortness of breath, abdominal pain, nausea, vomiting, or diarrhea. VS include T...