A 34-year-old female with medical history notable for varicose veins presents with complaint of left medial thigh pain. The patient states the pain started 3 days ago. She denies any fevers. She states the area is very painful to the touch. No antecedent trauma or injury. She has been taking Tylenol with minimal relief. She has a remote history of varicose vein ablation to her left leg..
Read MoreA 30-year-old female with a history of bipolar disorder presented after intentional lithium overdose. The patient reported feeling increasingly depressed for several weeks with intermittent suicidal thoughts. She reported getting into a verbal altercation with family while drinking alcohol and subsequently ingested a nearly full bottle of lithium (approximately 40 tablets, each with a concentration of 300 mg). She reported mild blurred vision and anxiety, but otherwise denied any other subjective complaints…
Read MoreA 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?
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