History of Present Illness: The patient is a 44-year-old male with a past history of end stage renal disease on hemodialysis, diabetes, and hypertension who presents with acute visual disturbance after assault 2 hours prior. He was struck in the eye by his partner’s fist (adorned with a large ring), but denies severe pain. He does endorses instant difficulty with his vision. There is no use of contacts or glasses. No other injuries, headache, or loss of consciousness are reported.
Chief complaint: Double vision
History of Present Illness: 61 year old female with history of HTN, DM, hyperlipidemia, and chronic low back pain presenting with double vision. She received an epidural spinal injection yesterday for the 4th time for low back pain. She was sedated for the procedure and woke up with headache, neck stiffness, and left eye “jumping around,” which progressed to double vision 1 hour later.
There was no blurry or double vision with either eye closed. She had 1 episode of emesis. She presented to the ED 24 hours later with continued headache and double vision.
History of Present Illness: A 31 year old African-American male, with a history of HIV, non-compliant with medications, presents with 3 months of painful “balls and bumps” on his left thigh. He was evaluated at another hospital prior to this visit and was discharged with 7 days of TMP-SMX. He denies any fever, chills, weight loss, night sweats, or anorexia.
Applying for residency programs has often been compared to the modern world of dating. So in this 26th installment of the EM Match Advice series, we discuss finding the right-fit program for applicants using modern dating terminology. Join us in this fun and informative episode in navigating the residency match process.(more…)
A 45-year-old male presents with right knee pain after he pivoted and felt a “pop” while making a move playing pickup basketball. You obtain knee x-rays and see a lateral irregularity in the AP view (photo courtesy of Dr. Gerry Gardner at Radiopaedia.org).
What is the most likely diagnosis, commonly associated injury, and appropriate management plan?
Mastering procedural sedation can make your shifts safer, more efficient, and more comfortable for your patients. But what defines a sedation? What and who do I need? Does my patient need to be fasting? How should I choose and dose my medications? Below is a brief guide to help you be more confident in your definitions, preparation, and medications. Included is a guide card you can print out and clip behind your badge! Read on and be a pro for your next on-shift sedation.(more…)