Category Name: em@3am

em@3am

EM@3AM: Sacral fractures

A 75-year-old male with a history of hypertension, osteoarthritis, and diabetes mellitus presents to the ED with a chief complaint of lower back pain.  He states that he fell a few days ago and the pain is getting worse, particularly when he is sitting down. His vitals include blood pressure 150/95...

em@3am

EM@3AM: Aortic Stenosis

An 83-year-old female presents to the ED with dyspnea at rest following a syncopal episode. Patient reports she was out for a walk with her husband when she began to feel lightheaded, short of breath, and then fainted. Triage vitals include BP 88/50, HR 115, RR 24, O2 98%. ECG is without signs of ac...

em@3am

EM@3AM: Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

A 55-year-old male presents to the ED for a rash of 2-day duration. He had URI symptoms for 4 days preceding the rash with myalgias and subjective fevers. He notes the rash began as small painless, erythematous papules but has progressed to larger, tender bullae. The rash began on his trunk and has ...

em@3am

EM@3AM: Bacterial Meningitis

A 21-year-old male is brought to the ED via EMS after a reported seizure. As per girlfriend, the patient began complaining of a headache yesterday, and today he is confused. He is febrile and tachycardic. He is confused and has nuchal rigidity. However, Kernig and Brudzinki signs are negative. CT is negative. What is most likely diagnosis, and what is the next step in diagnosis?

em@3am

EM@3AM: Cushing’s Syndrome

A 60-year-old female with diabetes and hypertension from skilled nursing facility presents with worsening mental status, shortness of breath, and muscle weakness. Vital signs include BP 175/100, HR 105, RR 22, SpO2 95% on room air, T 100.7F, and blood glucose of 275. Physical exam is remarkable for ...

em@3am

EM@3AM: Acute Hemolytic Anemia

A 3-year-old male with G6PD deficiency presents to your ED by ambulance with shortness of breath, found to be hypoxic with SpO2 80% on 15L NRBM. He appears pale and dyspneic. The child is placed on HFNC with no improvement of saturation. Given his persistent hypoxia on noninvasive methods, a decisio...

em@3am

EM@3AM: Rabies

A 13-year-old male presents to the ED for aggressive behavior which progressed to confusion and decreased level of consciousness. He initially was very agitated and aggressive and refused to drink any water. He then became disoriented and is now difficult to rouse. The parents note that he had recen...

em@3am

EM@3AM: Bartholin’s Abscess

A 36-year-old female presents to the ED with vaginal pain. She initially noticed a small bump one week ago that was only painful with sexual intercourse, but it has grown and now causes discomfort even when walking. Her temperature is 98.9oF, heart rate 78, and blood pressure 126/84. On exam she has...