It’s midnight on a Friday and your next patient just happens to have
been on the wrong end of a left hook. He is a 62 year old man who states
he was assaulted with a fist to the face while walking home.
EMS presents a 47-year-old male with sudden eye pain and decreased
visual acuity which occurred while he was putting drops into his left
eye. While he was retracting his lids to place the drops, his eye
“popped out” with sudden subluxation of the globe.
This 29-year-old female presented to the emergency department
complaining of feeling weak and dizzy. She admitted to being an IV drug
user and believed that someone slipped something into her food several
days ago while she had been at a truck stop diner. The patient also
stated that she was 10 weeks pregnant and recently restarted on
methadone for a “past” heroin addiction.
A 26-year-old male presented to the emergency department complaining of
severe left eye pain and loss of vision to that eye. He explains that
while cleaning he dropped a ceramic pot, which shattered, and a piece of
shrapnel stuck him in the eye. In addition to his visual complaints,
he’s been nauseous, and has vomited several times.
The case occurred at the San Antonio Military Medical Center – South
Campus (formerly known as Wilford Hall Medical Center) in San Antonio,
Texas. At the time of presentation the emergency department was a busy
Level II trauma center primarily serving active duty military personnel,
military dependents and select civilian personnel.
A 60-year-old man presents to the emergency department after a syncopal
episode. He had been drinking at a bar when he fell off the bar stool,
striking his head on the ground. He denied any chest discomfort,
shortness of breath, dizziness, palpitations or headache prior to the
incident. He came to the hospital only because EMS was called.
An assault to the face leaves your patient in need of an emergency
lateral canthotomy to relieve the pressure and preserve vision. Here is a
step-by-step pictorial guide, in case ophthalmology isn’t immediately
A 52-year-old male presented to the emergency department with four weeks
of shortness of breath and right sided chest pain. His symptoms had
gradually progressed in severity and were worse with exertion.
The Case: A 25-year-old male presented to the emergency department rapid
care center complaining of an infection to his left lower extremity. He
had a tattoo placed with red and green ink 2 weeks ago, and has noticed
progressively worsening redness and pruritis developing, and a
nonhealing wound with elements of the tattoo sloughing off.
The patient is a 24-year-old male with right hand inflammation and
discomfort after punching another human in the mouth 12 hours prior to
arrival. Patient had no past medical history and had no other injuries
and was without allergies to medication.