A 60-year-old man with a history of hypertension and smoking presents to the medical center with chest pain. Over the weekend, he developed chest pain while cleaning out his gutters that resolved with rest. This morning, he was working at his computer when he developed chest pain radiating to his left arm. It has since resolved, but he presents to the clinic for evaluation. An EKG obtained on arrival is unremarkable, but he soon develops chest pain again…
Read MoreA 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…
Read MoreA 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?
Read MoreA 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…
Read More“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…”
Read More
