Category Name: em@3am

em@3am

EM@3AM: Encephalitis

An 18-year-old female presents with confusion, seizures, and fever. Patient is unable to provide history, but her mother states that she began noticing confusion 2 days ago, and the patient expressed head discomfort yesterday. The patient appears lethargic and does not follow commands, and she is fe...

em@3am

EM@3AM: Tibial Plateau Fracture

40-year-old male is brought by EMS after being struck on his left side while crossing the street by a vehicle at 20 mph. He is visibly uncomfortable, laying on his right side, and refusing to move his left leg. His left lower extremity has an obvious effusion along with localized swelling and tender...

em@3am

EM@3AM: Acute Necrotizing Ulcerative Gingivitis

A 45-year-old male presents to the ED for worsening, severe oral pain and acute bleeding of his gums. He has HIV and is non-compliant on HAART. You note halitosis, gingival bleeding, increased mobility of the front lower teeth, ulcerated “punched out” lesions along the interdental papillae, and anterior cervical lymphadenopathy. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Anterior Shoulder Dislocation

A 35-year-old male presents with right shoulder pain. He was playing football with some friends, and as he was in the midst of throwing the football, a friend hit his throwing arm. He is holding his arm in an internally rotated and abducted position. You are able to detect an ulnar and radial pulse ...

em@3am

EM@3AM: Pneumothorax

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...

em@3am

EM@3AM: Peritonsillar Abscess

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...

em@3am

EM@3AM: Malaria

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?

em@3am

EM@3AM: Pancreatitis

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?