A 50-year old man with no known medical history (“I don’t see doctors. I don’t like doctors.”) presents to the ED because he crashed his car into a pole after driving after a “wintry mix” weather event (#…
A 78-year old man presents with abdominal pain and decreased oral intake. His vitals are normal but he looks uncomfortable. After you introduce yourself, you palpate his abdomen which is diffusely tender. Your immediate gestalt is “Sm…
Chief complaint: Hiccups (i.e. “singultus”). Timing: 3 days. Diagnosis: Persistent hiccups. Etiology: Unknown. Who cares? You care. Why? Because persistent hiccups (>48 hours) and intractable hiccups (>1 month!) is likely…
PEM fellow Dr. Michelle Vazquez presents a case of: A 6 month old boy comes to the ED with an elevated respiratory rate and lots of wheezing on exam. He had a tactile fever at home and in the ED his temperature is measured at 100.4F. His ox…
A young woman presents to the Emergency Department with chest pain of sudden onset while blowing up a balloon at her kid’s birthday party. Vitals are normal but due to slightly decreased breath sounds on the left, you are concerned fo…
Nurse: Doctor, this patient is a tough stick. I tried 3 times and I got nothing. Can you help? Doctor: Sure! I’ll grab the linear ultrasound vessel finder and get that line in for you, thereby potentially saving this non-critically ill pati…
Your 14 year old male patient fails the Ottawa Knee or Pittburgh Knee clinical decision tool after gettting whacked in the knee with some object of some kind or another. He’s tender near the tibial tuberosity and he refuses to extend…
A 75-year old man comes to your Emergency Department with an acute onset of left sided weakness and a facial droop. His NIH Stroke scale is 15. A stroke alert is called and the stroke fellow and her team race-walks to the Emergency Departme…
A 60 year-old male patient with a history of hypertension is BIBEMS with his spouse two hours of sudden onset memory loss. She noticed he began asking her if she wanted coffee every 3 or 4 minutes, apparently not remembering he had already…
by @benazan I have been surprised by the lack of pain in some patient with hip fracture. Most I have seen seem to be fine as long as the remain perfectly still. However, how often does that happen? After x-rays, multiple attending and resid…
