In the ED, their vitals/exam are as above. Patient with likely MSK pain due to chest trauma. Doubt myocardial contusion considering lack of significant mechanism, significant findings on exam, and normal EKG. No evidence of rib fracture considering lack of focal rib/costal TTP. Doubt PTX, pulmonary contusion, or hemothorax given availability of clear bilateral breath […]

In the ED, their vitals/exam are as above. With*** evidence of neurologic/vascular compromise. With*** evidence of deep tendon/muscle involvement. With*** evidence of deeper space infection. – Labs/Tests: Lactate, CBC, CMP, PT/INR, Type & Screen – Imaging: *** – Treatments: NPO, 2 large-bore IVs (18G or larger), Hemostasis (Simple pressure -> Pressure w/ QuikClot [preferred] or […]

In the ED, their vitals/exam are as above. No evidence of bite. However, given bat exposure with no ability for testing of that bat, will proceed as below. – Labs/Tests: None – Imaging: None – Treatments: Tetanus UTD, Rabies antibody into wound, Rabies vaccine (Day 0) into arm opposite of wound – Consults: None – […]

In the ED, their vitals/exam are as above. No concern for progression of the bite to cellulitis/abscess. No susicion for fungal infection given skin changes are not in intertriginous areas or necrotizing fasciitis as the patient’s pain not out of portion, rest of exam is not consistent with necrotizing fasciitis, and the patient is not […]

In the ED, their vitals/exam are as above. Ddx includes ascending urinary tract infection, postoperative infection, RP hematoma, lumbar strain, lumbar bruise, and sciatica. Lower suspicion for aortic dissection considering pain was not acute in onset and vital signs are stable fracture considering lack of focal midline TTP, cord compression considering lack of weakness/foot drop, […]

In the ED, their vitals/exam are as above.  Likely recurrence of patient’s chronic pain exacerbated by lumbar strain. Lower suspicion for fracture considering lack of focal midline TTP, cord compression considering lack of weakness/foot drop, cauda equina considering lack of bilateral radiculopathy/bowel or bladder incontinence/saddle sensory loss, epidural abscess considering lack of fever/IVDU/point TTP, pyelonephritis as […]

In the ED, their vitals/exam are as above. Likely recurrence of patient’s mild chronic back pain exacerbated by lumbar strain. Lower suspicion for fracture considering lack of focal midline TTP, cord compression considering lack of weakness/foot drop, cauda equina considering lack of bilateral radiculopathy/bowel or bladder incontinence/saddle sensory loss, epidural abscess considering lack of fever/IVDU/point TTP, […]

In the ED, their vitals/exam are as above. Patient with*** concern for cord compression considering with*** extremity weakness and with*** change in normal rectal tone. With*** concern for cauda equina considering with*** bilateral radiculopathy, with*** saddle sensory loss, with*** loss of bilateral ankle/knee reflexes, and with*** bowel or bladder incontinence/. Lower suspicion for acute fracture […]

In the ED, their vitals/exam are as above. Patient with*** concern for cord compression considering with*** extremity weakness and with*** change in normal rectal tone. With*** concern for cauda equina considering with*** bilateral radiculopathy, with*** saddle sensory loss, with*** loss of bilateral ankle/knee reflexes, and with*** bowel or bladder incontinence/. Lower suspicion for acute fracture […]

In the ED, their vitals/exam are as above. Patient’s presentation is consistent with prior episodes of storming with this episode likely being in the setting of constipation (vs. pain vs. infection) as detailed above. We will obtain labs/CXR to rule out infectious processes driving etiology. We will also treat pain given its potential as an […]