Category Name: em@3am

em@3am

EM@3AM: Basilar Skull Fractures

A 19-year-old male presents after an MVC. Another passenger reports that the patient hit his head on the seat in front of him. His GCS is 12, and you find hemotympanum, serosanguineous discharge bilaterally from the nares, and CN III palsy on exam. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Hyper- and HypoCa

A 59-year-old male with history of CML presents to the emergency department with left sided flank pain. He was sitting in a chair 4 hours ago when the pain suddenly started. The pain has been constant since onset. He appears uncomfortable, with mild tenderness in the LLQ. Testicular exam is normal. What is your presumed diagnosis, and what is the most likely contributor?

em@3am

EM@3AM: Post-Tonsillectomy Complications

An 8-year-old male presents 7 days post-tonsillectomy. His mother states he started spitting up blood this morning. The patient appears well, but suddenly starts throwing up coffee ground emesis. When the patient stops throwing up, you look at the back of the throat and see what appears to be a clot. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Ovarian Torsion

A 30-year-old female presents to the ED with sudden onset right lower quadrant and flank pain. She has also had severe nausea and vomiting. Abdominal exam reveals significant right lower quadrant tenderness, and pelvic exam reveals tender right adnexa. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Orbital Cellulitis

A 12-year-old male is brought to the ED by his mom for right eye swelling and pain. The patient reports pain with extra ocular motion and decreased vision in the right eye. You see extensive right eyelid swelling. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Mesenteric Ischemia

A 65-year-old male with a history of paroxysmal atrial fibrillation presents with diffuse, severe abdominal pain after eating. He is not on anticoagulation. He has had some bloody stool. What do you need to consider, and what’s your next step in your evaluation and treatment?

em@3am

EM@3AM: Pelvic Ring Fracture

A 23-year-old male is brought in by EMS from the scene of a severe accident. He is hypotensive and tachycardic, with a mangled right lower extremity and right upper extremity. EMS applied a tourniquet to both the right upper and lower extremity. Your initial primary survey reveals properly placed to...

em@3am

EM@3AM: Pericarditis

A 52-year-old male presents to the ED with chest pain that is left sided, sharp, and worse at night when he is resting flat. It is different from his prior angina. Physical exam is normal, and ECG shows diffuse ST elevations and PR segment depressions. What is the diagnosis?