Can’t Put My Finger on It

A 29 year old male resident presents to the local emergency department directly from the residency ski trip.  He was cruising down the slopes at  high speed, hit a hidden patch of ice and fell onto his right hand, hyperextending his thumb.  He tried to avoid coming to the emergency department, but the thumb remainsRead more

Face off

A 29 y/o M presents to your ED after a head-on MVC at moderate speed.  The patient was driving an older automobile without airbags, and smashed his face hard against the steering wheel.  He has significant facial ecchymoses and swelling, and you note clear fluid continuing to drain from his nose.  What injury will likelyRead more

Doc, He’s Acting a Little… Squirrelly

39 y/o F presents to your ED after a bite from a squirrel.  She was attempting to feed to squirrels in Central Park when one of them bit down hard on the index finger of her dominant hand, drawing blood.  She does not report any unusual behavior from the squirrel, although she admits she isRead more

Getting “nerve-ous”: Treatment of Occipital Neuralgia

39 y/o M no significant past medical history presents with severe right sided occipital headache since this morning.  The pain comes and goes, lasting a few minutes each time.  He has had these headaches before, and feels that this episode is consistent with his previous ones.  He denies fevers or chills, neck stiffness, numbness, tinglingRead more

Eye Caramba!: Management of Corneal Abrasions

A 25 year old male basketball player presents with R eye pain after being elbowed in the eye one hour prior to arrival.  The eye is tearing and very painful, although his vision is preserved, and he feels that something may be stuck in the eye. Exam of the eye shows PERRL, EOMI, 20/20 visualRead more

Management of Priapism: It Doesn’t Have to Be That Hard

A 12 year old patient with sickle cell disease presents to the ED with painful erection x 5 hours.   Urology is paged and suggests fluids, high flow oxygen, compresses to the area and exchange transfusion. They do not wish to aspirate blood from the penis in a patient this young, as they state thatRead more

Zosyn = Nosyn

A 56 y/o male with poorly controlled diabetes s/p multiple toe amputations presents with several days of fever and foot pain.  He is tachycardic and hypotensive and appears to have an infected foot ulcer. Vascular surgery is paged, and agrees come to see the patient, and in the meantime tells you to start Vancomycin andRead more