Category Name: em@3am

em@3am

EM@3AM: Methemoglobinemia

A 42-year-old female with a past medical history of iron deficiency anemia presents to the ED with a peritonsillar abscess. You give 2 benzocaine sprays and successfully aspirate the abscess. As she is waiting for her discharge paperwork, the nurse alerts you that her oxygen saturation is now in the...

em@3am

EM@3AM: Pink Baby

A 3-month-old male is brought in for increased work of breathing for the last 4 days. The patient has had no fevers or sick contacts. He was born full term without complications, is fully vaccinated, and has no familial medical history. Triage vital signs (VS): BP 85/50, HR 152, RR 56, SpO2 92% on r...

em@3am

EM@3AM: Grey Baby

A 3-day full term male presents with poor feeding and lethargy, looking grey. He is diaphoretic with feeds. He has not gained weight since birth. He is afebrile, tachycardic, tachypneic, grey appearing, with cool extremities and poor capillary refill. What should you consider?

em@3am

EM@3AM: Blue Baby

A 6-day-old male presents with increased work of breathing for last 4 hours and an episode of turning blue, which concerned the family. The baby is lethargic, afebrile, and cyanotic, with a weak cry to stimulation. There is a sunken fontanelle, perioral cyanosis with purple intra-oral mucosa, and b...

em@3am

EM@3AM: Marine Animal Bites and Stings

A 30-year-old male presents with intense left forearm pain after cleaning an aquarium at his job 20 minutes prior to arrival. He is unsure what kind of fish were in the aquarium. Physical exam reveals a patient who appears uncomfortable holding his left arm. There is a 5 cm area of erythema to his a...

em@3am

EM@3AM: Pacemaker/AICD Complications

A 69-year-old female presents with shortness of breath, orthopnea, and lower extremity swelling. She has a pacemaker placed 3 years ago for a complete heart block. She hands you her pacemaker identification card indicating that she has a single chamber pacemaker. Triage EKG: ventricular pacing spike...

em@3am

EM@3AM: Heat Stroke

A 72-year-old female is brought to the ED during a heat wave. Her daughter found her confused in her home. She believes the power has been out for several days. The patient appears lethargic and is intermittently confused. A rectal temperature reads 105.1F. The patient’s skin is warm and dry. She ...

em@3am

EM@3AM: Metacarpal Base Fractures

A 22-year old male presents to the ED after landing on his right thumb while playing football with some friends. The pain and swelling became progressively worse as he notes pain with any movement of his thumb. He is right hand dominant. On exam, the right MCP joint is edematous with point tenderne...