A 18-year-old male presents with chest pain and shortness of breath for several days. Approximately one week prior he was suffering from myalgia, congestion, sore throat, and fever and was diagnosed with an upper respiratory infection. Today his vitals are HR 132, RR 28, BP 92/48, T 37.8 C, and Sats 95% on RA. What should you consider, and what are your next steps?
EM@3AM: Myocarditis Read More »
A 58-year-old morbidly obese female patient with uncontrolled diabetes and peripheral arterial disease presents with an open wound to the central plantar aspect of her foot. She reports no pain, does not recall an injury, and is not sure how long she has had the ulcer. On exam, there is a 3.5 cm circular wound with thick yellow material in the center, and the edges of the wound are pink and warm to the touch. What is the diagnosis, and what are your next steps?
EM@3AM: Diabetic Foot Ulcer Read More »
A 6-year-old male presents with rash, joint pain, and abdominal pain. VS are normal, and exam reveals palpable purpura in the lower extremities. His abdomen is not tender to palpation, and his testicles are normal. Platelets and coagulation panel are normal. What is the diagnosis?
EM@3AM: Henoch-Schonlein Purpura (HSP) Read More »
A 20-year-old male college student arrives by ambulance restrained in a stretcher. Members of his fraternity called the police saying he became violent and agitated after “burning incense”. He is hypertensive and tachycardic with a normal blood glucose. What is the diagnosis, and what are your next steps?
EM@3AM: Synthetic Cannabinoid Intoxication Read More »
A 50-year-old male with uncontrolled diabetes presents with pain and swelling in his right foot. He does not recall any injury to the foot or leg. On exam, crepitus is noted on the foot and ankle. What is the diagnosis, and what are your next steps?
EM@3AM: Necrotizing Fasciitis Read More »
A 26-year-old male groundskeeper is sharpening a rusty lawnmower blade without eye protection when he feels a sudden pain and loss of vision in his right eye. What is the diagnosis, and what are your next steps?
EM@3AM: Open Globe Injury Read More »
A patient walks into your ED with a shirt covered in blood. He’s actively vomiting. Your triage nurses quickly get him into a wheelchair and roll him back to one of your critical care booths. You have little time to act to stabilize this critically ill patient. What are your next steps?
An 18-year-old male has been found unresponsive in a house fire with severe burns. VS in the field include T 37.5C, BP 144/77, HR 110, RR 15, Pulse Ox 98% on RA. You have minutes to prepare your team to care for this patient. What’s your next step in evaluation and treatment?
A 57-year-old female presents with right sided headache and mild fever (100.8 F). You note an enlarged, tender temporal artery with beading on exam. She denies vision changes. What is the diagnosis, and what are your next steps?
EM@3AM: Giant Cell/Temporal Arteritis Read More »
A 26-year-old female presents with fevers and chills. She is febrile and tachycardic, with normal BP. You think you hear a murmur on exam, and on further questioning, she says she regularly uses IV drugs. What should you consider, and what are your next steps?
EM@3AM: Endocarditis Read More »