Presentation Joey Tribbiani, a previously healthy 28-year-old male, presents to the ED with left-sided flank pain. In the past 12 hours, he has had four 20-minute episodes of sudden onset, severe left flank pain radiating to the groin. During these episodes he was unable to find a comfortable position. He felt nauseous and had one episode of emesis. He denies hematuria and any lower urinary tract, gastrointestinal, or respiratory symptoms. He reports no …
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. …
New Oncologic Therapies Mean New Oncologic Emergencies: An Approach to Immunotherapy-Related Adverse Events
A 63-year-old man, Andrew, presents to the emergency department with a several-day history of worsening diarrhea. He has abdominal pain rated 6/10, has been having over 8 loose stools per day for 4 days, and tells you he has seen some blood and mucus in his stools. He denies any nausea, vomiting, fevers or chills, sick contacts or recent travel. However, he tells you that he is under-going active treatment for Stage IV …
Case Report: Pregnancy and Trauma in the Game of Thrones
This is the 3rd Episode of the Game of Thrones Case Series. Be sure to also review Hypothermia and Traumatic Arrest in the Game of Thrones and Toxin-Induced Cardiac Arrest in Game of Thrones. Patient Presentation and History During the wedding of Edmure and Roslin, a young pregnant woman of unknown gestational age was found unresponsive with multiple abdominal stab wounds on the floor of the great hall at The Twins. Lord Frey allegedly planned …
Case Report: Toxin-Induced Cardiac Arrest in Game of Thrones
King Joffrey I Baratheon was found in respiratory distress by his mother, Cersei Lannister, and Jaime Lannister during his wedding to Margaery Tyrell. As this was the wedding for the King of the Seven Kingdoms, numerous guests and bystanders were present. The patient was eating a traditional pigeon pie and drinking from a glass of wine poured by Tyrion Lannister immediately prior to developing symptoms of dry mouth, severe cough, and shortness of …
The Long and Short of Needleless IV Extension Sets
While working nights with an EMS crew, you arrive on scene to find a 24 year-old male who was thrown from his vehicle at highway speeds. You estimate that there was 1500 mLs of blood loss visible on the road, with active bleeding from his left femur and abdominal guarding. After applying a C-spine collar, a pressure dressing, and moving him into the back of the ambulance, you start an 18 gauge IV …