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
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
The local fire department transported this 25 year-old male to the emergency department shortly after he was accidentally run over by a Bobcat skid steer at work. He reportedly had a transient loss of consciousness and was found lying prone on the concrete floor.
edited by Mark Silverberg, MD
A point-counterpoint discussion of relevant research