Fractures and Nerves

Board review: fractures/dislocations and associated nerve injuries: Acetabular fracture – sciatic nerve Anterior shoulder dislocation – axillary and musculocutaneous nerve Humerus – radial nerve Elbow dislocation – ulnar or median nerve Ole…

Retropharyngeal Abscess

  A 4-year-old boy comes to the ED with a severe sore throat and history of “refusing to eat”. He has severe pharyngitis on exam an you are concerned that he may have a retro pharyngeal abscess. What technique should be use…

E M Pearl, June 1

Tip of the hat to Raj Patel for inspiring this clinical question.   26F h/o lupus is brought into resus for positive sepsis screen at triage.  Patient c/o pleuritic CP, SOB, headache, n/v starting today. Vitals are 101.3  140  74/55  2…

E M Pearl, May 29

An 18 year old female presents to the peds ED after an episode of witnessed syncope. Pt was hiking when had sudden LOC, no preceding symptoms.  She now feels well and denies CP and palpitations. No prior episodes. No OCP use or other PE ris…

E M Pearl, May 25

Thank you to Papa Hernandez for this fascinating case.   37F 10 weeks pregnant (by LMP), asthma presents with 1-2 weeks of SOB. Extertional, +orthopnea, + bilateral LE edema. Has yet to initiate prenatal care. Her vitals at triage:  97…

E M Pearl, May 24

A 32F who is 14 weeks pregnant presents with intermittent shortness of breath x 1 day. She has no h/o DVT/PE. Vitals 98.9 100  105/70  18  99% on RA.  Clear lungs, no calf asymmetry on exam. You are concerned about PE. How should you procee…

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 p…

E M Pearl, May 18

3yo male h/o RAD presents with a nasal foreign body.  After a few conservative efforts to remove the FB, it is apparent the  child will not be able to cooperate with further attempts. A line is placed and 1mg/kg ketamine is given IV. While…

E M Pearl, May 17

Shout out to Ben Slovis for providing this case.   22F s/p thyroidectomy here with 1 day back pain and generalized weakness.  Patient’s thyroidectomy was complicated by inadvertent parathyroidectomy, and never followed-up to mana…

June 2024
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