A 53-year-old male presents with nausea/vomiting and complains of turning “yellow”. He denies abdominal pain, fever, alcohol use, or acetaminophen intake. His vital signs are normal, and exam reveals icteric sclerae, jaundice of his face and chest, and hepatomegaly. He has no tenderness to abdominal palpation. What’s going on, and what’s your next step in evaluation and treatment?
EM@3AM: Jaundice in Adults Read More »
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: Post-Tonsillectomy Complications Read More »
In this edition of emDocs Cases, we look at the evidence concerning rhabdomyolysis. What history/exam findings suggest the condition? Is CK level related to renal injury? What fluid is best? Are sodium bicarbonate and mannitol helpful? What’s the disposition? We look at these and more.
emDocs Cases: Evidence-Based Recommendations for Rhabdomyolysis Read More »
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 tourniquets. With inward pressure on the iliac wings, you detect pelvic instability. What’s the diagnosis, and what’s your next step in your evaluation and treatment?
EM@3AM: Pelvic Ring Fracture Read More »
Compartment syndrome is a condition we are always on the lookout for in the ED. How do you optimize diagnosis and management of this dangerous entity?
The Dreaded Acute Compartment Syndrome Read More »
A 43-year-old male right hand dominant man presents with pain and swelling of his left index finger. He is a professional painter and was using an industrial pain sprayer when he injected his left index finger. It now is exquisitely painful, with a large degree of swelling. What’s the diagnosis, and what’s your next step in your evaluation and treatment?
EM@3AM: High-Pressure Injection Injury Read More »
A 3-year-old male presents with his mom with chief complaint of vomiting and recurrent abdominal pain. Her son will intermittently cry and refuse to eat, followed by normal activity. His appetite has been decreased. VS are normal. Physical exam reveals a patient who appears stated age, nontoxic, and playful. Your physical exam, including abdomen and GU, is normal. The mom rushes out several minutes later and notifies you that her son is crying and holding his abdomen. What’s the diagnosis, and what’s your next step in your evaluation and treatment?
EM@3AM: Intussusception Read More »
Welcome to Part II of our evaluation of acute heart failure myths versus facts. This post will look at ED management of heart failure exacerbation.
Myths in Heart Failure: Part II – ED Management Read More »
We see heart failure on a daily basis. Where could we go wrong? This post will examine some myths and misconceptions in heart failure evaluation.
Myths in Heart Failure: Part I – ED Evaluation Read More »
A 23-year-old female presents with left foot pain after rolling her ankle in volleyball. She has some minor ankle pain, but her lateral foot is painful to touch or with weightbearing. On exam, the base of her 5th metatarsal is tender to palpation, with swelling and ecchymosis. What are your next steps, and what is the likely diagnosis?
EM@3AM: 5th Metatarsal Fractures Read More »
