Ouch, My Back

34 yo M BIBA s/p fall from 3 stories, suicidal attempt. Pt is AO3, CTA b/l, pelvis stable, able to lift all extremities off stretcher, sensation and peripheral pulses intact. Pt has right lateral heel/ankle deformity. +step off L1-L2 area, good rectal tone. Red trauma was activated. CT shows compression fracture of L1 with loss of vertebral height ofRead more

55 Chinese woman, no PMH, no meds.  P/w epigastric discomfort x 2 weeks, not responding to Pepcid Maalox.  Presented to Elmhurst ED for worsening epigastric discomfort and generalized weakness.  No fever/chill. + Mild dry cough.  No chest pain. + Mild SOB with exertion.  No abd pain, n/v/d/c/dysuria.  No night sweats or weight loss, denied exposure toRead more

E M Pearl, May 22

Thank you to Dr. Chris “This Ain’t No Simulation” Strother.   3 kids, 3 head injuries.   A) 2-month old boy, fell out of baby carriage onto top of head 30 minutes ago. No LOC, seizure, vomiting. Acting normally per mom. Abrasion on superior scalp, no palpable skull fracture, fontanelle flat.   B) 18-month oldRead more

Daily Em Pearl, 5/5/12

A young lady presents to your ED a few hours after a fist fight, c/o L-eye pain. She does not wear contacts and has tried ice and ibuprofen for the pain but noticed her eye was very red, so she came in for help. You do a complete eye exam, including visual acuity and aRead more

Daily Em Pearl, 5/4/12

A young lady is brought by friends on a makeshift stretcher. They have leaves in their hair and look frantic. They report that the patient went behind a tree to urinate, while on a hiking trip, and screamed after being bit on her L-forearm by a snake. They don’t know what the snake looked like.Read more

Daily Em Pearl, 5/3/12

A middle aged man presents to the ED after almost 2days of penile pain and swelling. The sx started suddenly, during intercourse and he didn’t present until now 2/2 embarrassment.  But now the pain has not abated, the condition has not improved and he hasn’t been able to urinate. He recalls missing the introitus and theRead more

Daily Em Pearl, 4/28/12

A teenaged woman presents at 32weeks gestation, c/o fingertip pain after experiencing a brief electric shock at home. How do you evaluate and care for this patient?  Read more

Daily Em Pearl, 4/21/12

An elderly man presents to the ED after falling down a flight of stairs at home. He has mild but worsening dementia and his wife called EMS when he couldn’t stand up from the fall. Your patient still does his own ADLs but is progressively forgetting things, like where he put his keys and toRead more

Daily Em Pearl, 4/18/12

Early in the morning, a young man p/w R-great toe pain after having his foot stepped on while dancing last night (a few hours ago). On exam, you appreciate full ROM and strength but your patient is pretty uncomfortable. He took paracetamol and ibuprofen at home with minimal relief. There are no signs of infectionRead more

Daily Em Pearl 4/16/12

A 55yoM is BIBEMS after an MVC c/o RLE pain w/obvious deformity at the thigh. Distally he is NVI but is in excruciating pain. The portable plain film shows a mid shaft fracture. You order dilaudid but he’s still really uncomfortable. How can you help him?  Read more