August 8, 2017
I’ll present this case in the actual sequence of events as they happened: A patient in her mid-50s presented to the ED with chest pain. She saw her PCP and had an ECG done, after which he suggested that she go to an ED for
August 1, 2017
A person is thumb-wrestling and suffers an unfortunate consequence. After the match, their ring finger is mostly tender and swollen around the MCP joint and stuck in a slightly flexed position. Here is the x-ray: Diagnosis: comminuted proximal phalanx fracture It doesn’t take much to
July 16, 2017
This is a real [reported] story of a lawsuit involving an ED physician in Ohio. — The summary: Michael Cleveland was grocery shopping when he had an apparent heart attack. He was taken to a hospital where, after resuscitative efforts, the ED doctor pronounced him dead.
July 11, 2017
A young healthy person slips on a banana peel and inverts his ankle. X-rays reveal: This is a trimalleolar fracture. Technically a person only has two malleoli (medial and lateral). A trimalleolar fracture involves both of these along with the posterior aspect of the
July 7, 2017
An elderly male presents with constipation. A KUB is ordered and this is what is seen (understandably it’s a poor quality film, but it’s the actual film that was obtained): The glaring abnormality is the coffee-bean-shaped colon; this patient has a sigmoid volvulus. Sigmoid volvulus
July 7, 2017
We work in a high-risk field. The very nature of emergency medicine and the types of patients it attracts is litigious. A 2011 study published in the New England Journal of Medicine found that EM had a higher than average risk of malpractice. It states:
July 2, 2017
We’ve all experienced this: your overnight shift is winding down, you’re trying to wrap up dispositions on all of your patients, and you’re tired. You either discharge some people a little prematurely (those fluids will finish, they’ll feel better, and they’ll be able to leave.
June 25, 2017
A healthy young guy presented to the ED after being attacked by a shark. He had heard that the best way to defeat a shark in a fist fight is to punch it in the snout. He did just that, and started celebrating as the shark swam
June 19, 2017
The next chart up is a healthy 12-week pregnant woman with vomiting. Labs have already been ordered and are normal. You decide to forego the IV and give her a Zofran dissolvable tablet – saving her time, needle stick, and the pain of having to
