A 24 year old female presents to the ED complaining of a worsening headache after a lumbar puncture performed in the ED 2 days prior which diagnosed idiopathic intracranial hypertension. "No problem!" you think. Either this is just a post LP headache or possibly the patient needs more CSF drained to improve her headache. LP is a very safe procedure with minimal risk after all! Right?
A 23 yo male with a hx of insulin dependent diabetes and recurrent admissions for DKA presents to the ED with complaints of diffuse body aches. He is acutely ill appearing, agitated, and combative with staff, demanding pain medication, entering other patients rooms, and screaming. Realizing that this patient is severely ill, you wonder how you will de-escalate or sedate this patient safely to enable life-saving care to be rendered.....
A 63 yo male presents complaining of severe pain to the right shoulder. He has markedly restricted range of motion in the shoulder, without any overlying erythema, edema, or warmth. You take a cursory glance at the xray as you gather supplies to perform an arthrocentesis for suspected septic arthritis...
A 54 year old man presents complaining of "restlessness" and within a few minutes of talking you realize he is likely in acute alcohol withdrawal. What next???
A 50 you male with history of gout presents with severe pain and swelling of the right hand third PIP joint for one week. History of gout and mono-articular joint pain/swelling? Easy, right? Right???
A 50 you male with history of gout presents with severe pain and swelling of the right hand third PIP joint for one week. History of gout and mono-articular joint pain/swelling? Easy, right? Right???
A 36 year old male presents with complaints of swelling his his hands and forearms, as well as severe fatigue and muscle aches. He is in no distress and vital signs are unremarkable. "Time to put on my internal medicine cap!" you think as you sit down to take your history and puzzle out the differential diagnosis.....
A 21 yo male presents after a ground level fall while intoxicated. His arm is obviously deformed. Time to shoot some xrays and find some plaster!
A 55 year old male presents after an altercation at a bar. The EMT warns you that his right eye "looks pretty weird" as they transfer him to the ED stretcher....
A 68 year old male presents with ALS for near syncope at home. ALS reports they found the patient diaphoretic, complaining of generalized weakness and inability to stand which began acutely an hour ago. His blood pressure on scene was 60/palp, which improved to 100 systolic with a 500 ml IVF bolus. "Shock eh?" you think as you approach the room. "Better bring the ultrasound...."
