A 7 year-old girl presents after falling off a jungle gym. She has a visible deformity of the left humerus and wrist. She won’t let the nurse get close enough for a blow-dart, let alone an IV, and your attending slaps the IO kit out of your hands as you desperately try to boost your procedure numbers. She needs pain relief. Now what?
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A 31 year old female with no significant PMH presents to the Emergency Department with left-sided chest pain that started suddenly 3 hours ago while sitting in a lecture hall. She describes the pain as a constant stabbing sensation in her left anterior chest that radiates to her left neck. She endorses feeling short of breath and lightheaded. She has never had a sensation like this before. The patient denies smoking, fevers, chills, and trauma. Her vital signs are unremarkable, and her physical exam is notable for decreased breath sounds in the left upper lung field…
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