The differentiation between peripheral vertigo and central vertigo can be exceedingly difficult as symptoms of both clinical entities largely overlap. This diagnostic dilemma can be particularly painful for Emergency Medicine physicians and their patients as the workup for central vertigo rules out "can't miss" pathology with imaging that typically takes hours to obtain.
Case: A 68 year old woman presents to the ED with fever, hypotension, and AMS. She has a PICC in place. Your overzealous intern places a central line, and he swears the stick was venous. You obtain and CXR to confirm line placement. Where does the line terminate?
Case: An 8 year old girl presents to the Emergency Department with the feeling of shortness of breath. Onset was soon after a meal and her parents state that she may have choked on something.
Case: A 42 year old female patient with a past medical history significant for diabetes, obesity and hypertension presents to the ED with chief complaint of 4 days of abdominal pain.
Penetrating neck trauma is a serious cause of morbidity and mortality in the acutely injured patient. While a "no-zone" management approach to penetrating neck injuries is replacing the traditional three zone approach, knowledge of neck zone anatomy is crucial to anticipating and diagnosing pathology inherent to each zone. Zone I is the most caudal and includes the base of the neck and thoracic inlet.
Case: 55 year old female with unknown medical history presents to the Emergency Department by EMS after having a seizure. Prior to the seizure the patient was found "acting strangely" and agitated outside on her street. Patient had a witnessed seizure after police arrived.