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April 2008 Challenge

48-year-old Amish female transferred via lifeflight after an auto vs. buggy accident. The patient is intubated at the scene for a GCS 6. Her vitals on arrival are as follows: BP-84/50, HR 142, RR- 20 (bagged) and PO-100%. On examination, she has multiple bruises noted on her torso and extremities. Her...

Posted to EMsono Challenge (Weblog) by Rob on 04-20-2008
Case of the Week - Case # 66

An 87-year-old female nursing home resident presents to the ED hypotensive after a fall. The patient has a history of organic brain syndrome, a fib on coumadin, hypertension, coronary artery disease, hypothyroidism and gout. The patient is nonverbal. Her vitals signs are as follows: BP 62/40, HR 108...

Posted to Cases (Weblog) by Rob on 03-04-2008
Case of the Week - Case # 62

A 24-year-old male presents after having been stabbed to the anterior right hemithorax with a screwdriver. His vital signs are stable and his pulse ox is 95% on room air. You perform a FAST exam and note the following on the perihepatic window. Take the Case

Posted to Cases (Weblog) by Rob on 02-06-2008
Case of the Week - Case # 61

A 23-year-old female presents with vaginal bleeding and lower abdominal pain. She is approximately 6 weeks pregnant by date and has a positive bedside UCG. Her vitals are as follows: BP 88/46, HR 122, RR 24 and T 37.1C. Her physical exam reveals moderate lower abdominal tenderness with guarding. She...

Posted to Cases (Weblog) by Rob on 01-30-2008
Case of the Week - Case # 58

A 41-year-old male presents with severe midepigastric abdominal pain and hypotension. The patient states he has had no trauma and developed the pain 2 days ago and it has gotten progressively worse. His vitals are as follows: BP 78/54, HR 138, RR 28 and T 38.1 C. You perform a FAST exam in order to better...

Posted to Cases (Weblog) by Rob on 01-10-2008
Case of the Week - Case # 57

A 32-year-old male presents to the ED after being shot. He has an entrance wound noted at the anterior axillary line near the lower costal margin. An upright chest radiograph reveals no intrathoracic trauma. The bullet's location is not seen on the chest radiograph. The patient's vital signs...

Posted to Cases (Weblog) by Rob on 01-01-2008
Case of the Week - Case # 55

An 86-year-old nursing home patient presents to the ED with dyspnea and low blood pressure. Her EKG reveals low voltage QRS complexes and your resident is concerned that the patient has a pericardial effusion/tamponade. Your resident is also concerned that "something doesn't look right in the...

Posted to Cases (Weblog) by Rob on 12-17-2007
Case of the Week - Case # 44

A 36 y.o. female presents after a rollover MVC. On examination, she has a right wrist fracture, left femur fracture and left ankle fracture. In addition, she has numerous thoracoabdominal bruises noted and a large scalp laceration that appears to have bleed a significant amount. She remained hemodynamically...

Posted to Cases (Weblog) by Rob on 09-23-2007
Case of the Week - Case # 42

A 24 y.o. female presents via EMS after being ejected from a vehicle in a rollover MVC. On arrival, her GCS was 3 and her vitals were: BP 100/64, HR 118, RR 20. The patient has multiple torso bruises and is noted to have diminished breath sounds on the left. After the patient is intubated and the initial...

Posted to Cases (Weblog) by Rob on 09-08-2007
Case of the Week - Case # 41

A 36 y.o. male is admitted to the ED via EMS after a high-speed MVC. The patient was the unrestrained driver of the vehicle. The medics report that the patient "broke the steering wheel. It was also noted on exam that the patient has extensive bruising in the upper abdominal region. His physical...

Posted to Cases (Weblog) by Rob on 08-27-2007

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