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...
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 ...
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...
A 40-year-old female presents to your Emergency Department with three days of pain and swelling in her right index finger. On exam, her right index finger is diffusely swollen, erythematous, and held in flexion. There is a punctate wound on the dorsal finger distal to the DIP. She has significant...
A 13-year-old male is brought in by EMS for altered mental status after being found in a house fire. The fire department found burned couches in the house with melted plastic covering. His vital signs include BP 78/40, HR 155, T 99.9 Oral, RR 40, SpO2 92% on 15L NRB. He is somnolent but withdraws to...
A 28-year-old male presents to the ED with right shoulder pain after falling on an outstretched arm two hours earlier. He denies history of prior shoulder injuries. On exam, he is holding his right upper extremity in adduction and internal rotation at the shoulder. He is unable to externally rotate ...
A 22-year-old female presents to the ED after taking an entire bottle of unknown medication approximately an hour and a half ago. She describes a ringing sensation in her ears and mild nausea with no vomiting. Triage vital signs (VS): BP 122/75, HR 115, T 99.8 Oral, RR 32, SpO2 99% on RA. She is t...
A 51-year-old male with diabetes mellitus presents with pain in his left foot, as well as fever and chills. His physical exam is notable for a 3 cm ulcer over the plantar aspect of his left first MTP joint, with surrounding warmth and erythema. Using a sterile instrument, bone was easily probed. What is your next step in evaluation and treatment?
