Case: 18-year-old Arthur comes to the emergency department complaining of sudden onset pain in his testicles that woke him up at 4 am. Arthur had noticed that part of his testicle appeared swollen when he awoke. This concerned him, since he didn’t remember an injury. He tried applying ice, but after a while of no relief, his parents drove him to the local ED. His pain has increased and is now (at 7 …
Substance use in the ED: Alcohol Use Disorders and the Emergency Department
Think back to your last three shifts. Did you see an alcohol related condition? You might even notice a pattern— the same patient, the “regular” who returns time and time again with the same presentation. You may even find yourself writing “discharge home when ambulatory” as you’ve “reached your wits end” and don’t know what to do anymore. The use of alcohol is common and the emergency department is often where we see …
Tiny Tips: OSTRICH as a differential for acute monoarthritis
Acute monoarthritis is a common complaint in the emergency department. The differential for acute monoarthritis is broad. A delay in proper diagnosis and treatment of certain etiologies can result in significant morbidity.1,2 The evaluation of a patient with acute monoarthritis should begin with a focused history and physical exam which will guide further laboratory and radiographic studies. With a history of trauma or focal bony pain, radiography can be useful to rule out …
Case Report: Penetrating Chest Trauma in the Game of Thrones
This is the 4th episode of the Game of Thrones case series examining penetrating chest trauma. Be sure to review Hypothermia and Traumatic Arrest in Game of Thrones, Toxin-Induced Cardiac Arrest in Game of Thrones and Pregnancy and Trauma in Game of Thrones. This post contains spoilers from Game of Thrones Season 8! Patient Presentation and History A 23-year-old female was seen unresponsive with a single penetrating wound to the left anterior chest. …
Managing headaches in pregnancy
An approach to headache in pregnancy, including workup and treatment options!