Posts in Community EM
A Flare in the ED: Using Ultrasound to Diagnose Gout

A 53-year-old male with hypertension presents to the emergency room with painful swelling of the right first toe at the MTP joint. The patient was in good health until a few days ago, where he was attending a college reunion. The swelling and pain increased overnight. The patient is having difficulty walking this morning due to the pain. He tried taking two Advil for the pain, which helped bring the pain from an 8/10 to a 6/10…

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When laughter isn’t the best medicine: The serratus anterior plane block for multiple rib fractures

A 67-year-old man presents to the emergency department after a mechanical fall from standing. During his trauma evaluation, he is found to have severe right-sided chest wall tenderness. His imaging demonstrates multiple right-sided rib fractures with an otherwise unremarkable workup. The patient is in significant discomfort and is given acetaminophen and morphine. Despite this, he remains in severe pain and has difficulty taking deep breaths. The patient is given an incentive spirometer and his maximum vital capacity is measured at 500 ml. What complications is this patient at risk of developing? What interventions can be performed in the emergency department to help manage his pain?

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A Case of Recurrent Urticaria

A 50-year-old male with no significant past medical history presents to the Emergency Department with a chief complaint of facial swelling. The patient had been in his usual state of health when he awoke suddenly in the middle of the night just prior to presentation with lip swelling and an urticarial rash on his back and neck. He denies dyspnea, wheezing, trouble swallowing, nausea, vomiting, or diarrhea…

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To Treat or Not to Treat: Below the Knee DVT

“A 42 year old male with a past medical history of paroxysmal atrial fibrillation and L4 radiculopathy due to a remote back injury presents to the ED with chief complaint of right foot and calf pain. The pain is described as cramping and burning that gradually worsened over the 3 days prior to presentation. He is not on anticoagulation. He denies…”

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