Disseminated Lyme

A 33-year-old male presents to the ED with ongoing left lower extremity pain and a few days of malaise. He has a history of bipolar I disorder, as well as chronic alcohol, tobacco and marijuana use. He first presented to his primary care doctor six days ago with erythema and pain over the left medial malleolus. At that time he had no other symptoms and physical exam was otherwise unremarkable. He was treated for presumed cellulitis with doxycycline, which he took at half of the prescribed dose due to a miscommunication with his doctor…

Community EM, Dermatology, Infectious DiseaseKatherine BarrySeptember 26, 2022Lyme Disease, Disseminated LymeComment

ED Approach To Dizziness

A 55 year-old-male presents to the emergency department complaining of dizziness…

Community EM, Critical Care, NeurologyKatherine BarrySeptember 26, 2022Dizziness, Neurology, Cerebellar MassComment

A Case Of A Young Man With Extremity Paresthesias

A 29-year-old male with no significant past medical history presents to the emergency department for evaluation of progressive numbness and burning sensation to his bilateral hands and feet. He reports the symptoms have become so severe that he has started to have difficulty using his hands. He also states that he has had difficulty ambulating at times. He endorses neck pain and intermittently experiences a sensation that feels like “shocks down my spine” with movement of his neck…

Community EM, NeurologyMeredith HortonSeptember 23, 2022Neurology, Paresthesias, B12 DeficiencyComment

Domestic Violence and the Emergency Department Patient

A 25-year-old woman with a past medical history of anxiety presents to the emergency department with right sided chest pain. She describes approximately two hours prior to arrival, she tripped in the bathroom while bathing her child, striking the right side of her chest on the tub. She denies head strike or loss of consciousness, shortness of breath or abdominal pain…

Community EM, Legal, Public Health, Social EM, Harm ReductionKatie MillerSeptember 16, 2022Domestic Violence, Intimate Partner Violence, Elder AbuseComment

EPSS As a Proxy for Ejection Fraction

A 68-year-old male presents to the emergency department (ED) with one week of worsening shortness of breath. He has no known cardiac history and has rarely seen a physician. He reports shortness of breath with exertion, mild non-productive cough, and subjective fever. He is not having chest pain. He is a long-time smoker but denies other drugs. Vitals are as follows: heart rate (HR) of 102, blood pressure (BP) of 105/70, afebrile, 89% on room air (RA), respiratory rate of 20. On exam the patient exhibits labored breathing, crackles in bilateral lower lung fields and +1 pitting edema in bilateral lower extremities…

Cardiology, Community EM, Medical Education, UltrasoundConnor WilsonJuly 22, 2022EPSS, Ultrasound, Cardiology, Emergency Medicine, EM, Cards, ECHO, LVEFComment

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