Andy is a 9-year-old male presenting to the emergency department after a left sided FOOSH injury. The initial survey indicates no other associated injuries or neurovascular compromise. However, Andy is holding his left arm and describes a poorly localized pain along his wrist and forearm preventing him from moving it. His immunizations are UTD and he is otherwise healthy without any history of orthopedic injuries. What are your differential diagnoses? What findings on …
The Simple Guide to Management of Non-Valvular Atrial Fibrillation in the ED
Case Presentation Mohammed is an otherwise healthy 58-year-old male presenting with a 24-hour history of palpitations and light-headedness following rigorous exercise. He denies chest pain, shortness of breath, diaphoresis, syncope, or focal neurological symptoms. He has no previous chronic conditions or hospitalizations. No alcohol or drug use. On exam, Mohammed appears somewhat anxious but is not in distress. He is tachycardic at 130, with vitals otherwise within normal limits. Cardiac exam reveals an …
Approach to Corneal Disorders in the ED
View PostI heard a snap! Clay Shoveler’s Fracture
Reginald, a 73-year-old man, presents to your Emergency Department with neck pain. He tells you that last night he was straining to lift a heavy box. He heard and felt a snap in his neck. This morning, he awoke with neck pain, dizziness, and mild confusion. You examine Reginald and find that he has pain with neck rotation, flexion, and extension. He also has exquisite, sharp tenderness on palpation over the C6 vertebrae. …
When and how to treat hyponatremia in the ED
Electrolyte imbalances like hyponatremia can be the cause of a variety of vague complaints. At the same time, patients may present with electrolyte abnormalities that are asymptomatic and are incidental findings on bloodwork. Here’s an approach to deciding when and how to treat hyponatremia in the emergency department. We also thank Drs. Joel Topf (@kidney_boy) and Dr. John Neary (@jddneary) for their valuable input on this article! The Case Marjorie, an 83-year-old female, …