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.

A 16-month-old female presents to your emergency department with her mother after stepping on a bare wire left plugged into a wall. The child has no past medical history and is up to date on all vaccinations.

In the February issue of Emergency Physicians Monthly the following reader case file was posed to the group and the question asked how would you respond? What would be your solution? The following is how the case was resolved at the time as well followed by the reader suggestions and comments.

It was a surprisingly quiet early May morning in a Midwest emergency department. I was partway through a coffee and enjoying the pace of the morning when the dreaded squad phone rang. We all got a quick chuckle as the nurse noted a local squad bringing in a 16-year-old male with a turtle bite

A 28-year-old emergency physician is bitten by a diamondback rattlesnake on the right middle finger. He applies a tourniquet and arrives to the hospital approximately four hours after envenomation.

A 62-year-old woman entered the emergency department (ED) with a chief complaint of a snake envenomation to the left foot about one hour ago while hiking in a southwestern mountain trail. She reports the snake was small and tan and she did not see a rattle. The patient has no medical problems and states the pain in 2/10 and only present at the left foot.

This 56 year-old homeless, alcoholic male presented to your emergency department complaining of generalized malaise, diffuse bony aches and a rash to his lower extremities. The symptoms had been present for 2 weeks without any fever, chills or known sick contacts, and the rash was noticed 1 week ago and was progressing.

A 56-year-old man presented to the emergency department complaining of bilateral ear pain and eye redness. Ten days ago, he noticed right ear swelling and pain and treated this at home with cold compresses. These symptoms seemed to improve, but over the next few days his left ear began to swell. Both eyes subsequently became red and extremely painful with tearing and photophobia associated with an intense retrobulbar headache.