Posterior Reversible Encephalopathy Syndrome (PRES) in the Emergency Department

68-year-old male with history of hypertension, chronic kidney disease presenting from home with wife at bedside for confusion and shaking movements. Per wife, the patient is independent at baseline. He walks, drives and still works. Yesterday, he complained of a mild headache and this morning she noticed he seemed more confused, described as asking repetitive questions and wandering around the house. Prior to coming into the emergency department, the patient had a one-minute episode of full body shaking. This has never happened before. He has no history of seizure activity. The shaking resolved on its own and the patient was very tired afterwards while awaiting the ambulance. ..

Community EM, Critical Care, NeurologyKatie MillerFebruary 19, 202355 Claverick StPRES, Hypertensive EmergencyComment

Posterior Shoulder Dislocation

A 46-year-old male with no past medical history presents to the ED via ambulance after crashing his bicycle. He was traveling at 25 mph when a dog ran out in front of him, causing him to swerve and fall onto his left side. He was helmeted and did not lose consciousness…

Community EM, Sports Medicine, OrthopedicsKatherine BarrySeptember 26, 2022Posterior Shoulder Dislocation, Reverse Hillsachs, OrthopedicsComment

Lunate Dislocation

A 51-year-old male with no past medical history presents to the ED with wrist pain after a fall. Earlier today, he lost his balance and fell down 12 stairs, landing on his outstretched hand. He has had increasing swelling of the radial aspect of his left wrist as well as extreme pain with movement. He did not strike his head or lose consciousness, and reports no other injuries…

Community EM, Sports MedicineKatherine BarrySeptember 26, 2022Lunate Dislocation, OrthopedicsComment

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

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