A 19 year-old male presents to the emergency department with a complaint of right shoulder pain. He was tackled from behind in a rugby game three days prior to presentation and has been experiencing pain over the anterior aspect of his right shoulder since that time. Physical exam is notable for tenderness over the right acromioclavicular (AC) joint and pain with both active and passive range of motion of the right shoulder. X-rays (Figure 1) show “no obvious fracture or subluxation.” However, based on your exam and clinical suspicion, closer inspection reveals abnormal alignment between the clavicle and the acromion consistent with AC joint injury…

OrthopedicsAlexander DaytonJuly 26, 2019Orthopedics, Acromioclavicular Joint, Shoulder traumaComment

AEM Early Access 29: Do Financial Incentives Change Length of Stay Performance in Emergency Departments?

AEM Early AccessGita PensaJuly 25, 2019Comment

Seatbelt Sign of the Neck in Pediatric Trauma

The patient is a 11 y.o. male with no past medical history who presents as trauma activation after MVC. Patient was the restrained front seat passenger in a head on collision. Denies LOC. Per EMS, patient was found in police cruiser on arrival, patient states he walked at scene. +Seatbelt sign. Vitals stable. Patient states his pain is worst in his neck, rates pain 6/10. Denies numbness/tingling…

Pediatrics, TraumaGuest UserJuly 12, 2019Pediatrics Comments

Brown EM Whit-ticisms: Epinephrine Auto-Injectors

Community EM, Education, Whit-ticismsWhit FisherJuly 1, 2019#FOAMed Comment

Pediatric Baclofen Overdose

A 16 year-old male presented to the emergency department after intentional overdose of 200 mg of baclofen. The patient was found in his bedroom by family members approximately 10 hours after ingestion with reported twitching, vomiting, unresponsiveness, and possible seizure activity. On arrival to the emergency department, the patient was awake, alert, and oriented; tearful, but otherwise asymptomatic…

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