Cerumen Impaction: an Update.

The last time www.sinaiem.org addressed the topic of cerumen (ear wax) impaction was in 2013. See this post: http://sinaiem.org/50yo-man-with-chest-pain-and-also-with-r-ear-pain/  If you’re like me, you likely believe that the world of ceru…

Gum pains

25 y/o F with multiple painful lesions of the right gingiva and low grade fever. The symptoms started off as a stinging sensation with sensitivity to the gums on her right side that she noticed 3 days ago, but now there are lesions that hur…

Peek Through the Orbit

32 yo overweight female presents with a headache.  This headache is similar to prior headaches, which she gets frequently.  The rest of her story seems consistent with a migraine and her physical exam, including a through neuro exam, is nor…

Its a Bleeder

A 50 y/o M with a PMH of hypertension presents to the emergency department with epistaxis. A rhino rocket is placed. You note the patient’s blood pressure to be 196/100. He is A&Ox3 and denies any other symptoms. Should you treat…

Lump in My Throat…

A 19-year-old-male with no known past medical history, presents in progressive respiratory distress shortly after undergoing a tooth extraction about 6 hours prior to presentation. Symptoms began initially as “a lump in his throat” and diff…

My Face is Swollen!

A 15yo girl comes into your ED complaining of unilateral facial swelling that started this morning as a little bit of swelling under her R ear, and 8 hours later, is now her entire R cheek. No fevers/chills. ROS otherwise negative. VS norma…

A 60 yo F with sudden onset loss of vision in right eye, painless.  Proceeded by a few episodes of amaurosis fugax. Physical exam: pupils appear normal on initial inspection, however afferent pupil defect noted. Fundoscopic exam: cherry red…

E.m. Pearl, May 10

19M brought into pediatric resus looking toxic, diaphoretic with shallow breathing.  Temp 38.7, HR 126, BP 146/51,  RR 20,  95% on RA. Two weeks ago he had a sore throat which was strep and monospot negative.  He’s had a persistent so…

Daily EM Pearl 4/6

A 53yoM presents with bilateral TMJ dislocation which he has had in the past. He receives procedural sedation and multiple attempts at reduction using conventional methods with no success. What can be done now?

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