A 24-year-old woman is brought to the emergency department (ED) after being discovered with a decreased level of consciousness in a local mall bathroom. Two doses of intranasal naloxone were administered on-site by bystanders. After receiving naloxone, her LOC improved, though she was still mildly sedated upon arrival to the ED. After 1-2 hours in the ED, she is alert and reported using 0.5g of smoked fentanyl prior to the episode. You learn …
Exam Series: Guide to the Shoulder Exam
A 58 year old right hand dominant painter presents to the emergency department with right shoulder pain. The pain started after he returned a particularly forceful serve during a tennis match earlier that afternoon. He states that it has a similar quality to the shoulder pain he typically feels at night, but more intense and not improving with analgesia. He did not feel a “pop” or other mechanical symptoms, but has dislocated that …
Exam Series: Guide to the Back Exam
A 67-year-old male presents to your emergency room with back pain. He has a history of intermittent back pain that typically responds to NSAIDs, however this particular episode has been much more severe. He now feels sharp pain that radiates into this left foot with certain movements, which causes weakness when walking. His past medical history is significant for a right hemicolectomy, hypertension, type II diabetes, and smoking. He has no history of …
Exam Series: Guide to the Knee Exam
A 22 year old female comes to emergency department unable to walk. She was in the middle of a rugby game when she caught the ball while pivoting quickly, and was tackled shortly thereafter. She immediately heard a “pop” and says that the swelling in her right leg has increased substantially over the last hour. Background: The knee is a complex hinge joint and one of the most common sites of MSK injuries. …