altA 47-year-old male presents to your emergency room following a motor vehicle accident. The second year resident gathers in the history that he was a restrained front-seat passenger in a car that was traveling approximately 45 mph when the car was rear-ended. Airbags were deployed and the remainder of the passengers in his car were unharmed.

altA 49-year-old, right-hand- dominant male presents to the emergency department with right shoulder pain. The patient was playing volleyball and immediately after spiking the ball felt severe pain to the right shoulder. He was unable to lower the arm, and states that he feels numb over the arm and fingers.

altDistal radial fractures are among the most common fractures in childhood, and are a frequent presenting complaint in the emergency department. Traditionally, ED management of displaced distal radial fractures in children has included closed reduction and splinting of displaced fractures, usually under sedation.

altAn 89-year-old female presented to the emergency department with a three to four day history of gradually worsening, sharp right lower quadrant abdominal pain without radiation. On the day prior to the emergency room visit, a hard, tender mass developed in the area of discomfort. The patient usually had regular bowel movements; however she had not had a bowel movement for the past three days.

altA 40-year-old Hispanic female presented to our Emergency Department complaining of upper abdominal pain, nausea and vomiting for 1 day. She denies fever; last bowel movement was the previous day. She has no history of prior abdominal surgeries and past medical history was unremarkable. Vital signs were normal except for tachycardia at 112 bpm.

altConsider this scenario. You’re nearing the end of another busy shift in the emergency department but muster the energy to pick up one more chart…a healthy 65-year-old female with a foot injury. The x-rays are done. Should be a quick dispo, right?

altA 45-year-old woman presents to the ED with two days of abdominal pain which was gradual in onset and became severe and diffusely distributed...

altA 23-year-old male presents to the Emergency Department (ED) with 4 days of a persistent sensation of a ‘fish bone’ stuck in his throat. Patient ate fish tacos 4 nights prior to arrival. The patient describes feeling a sharp foreign body stuck along the right side of his upper throat, just proximal to the angle of his mandible. The pain is worse with swallowing, and turning his head to the right.

altAn 11-year-old female with no significant past medical history, presents with a five day history of right shoulder pain. The patient’s mother reports that the patient was “horsing around” with her older brother five days ago. She attempted to slap her brother using her arm when she immediately felt a “popping” sensation in her right shoulder. She was taken to a local emergency department where she was evaluated, imaged, and discharged home with the diagnosis of “shoulder strain”.

altBefore starting efforts at intubating any airway with laryngeal pathology, it must be appreciated by all caring for the patient that rescue ventilation may not work if the epiglottis or larynx is swollen or distorted. This applies to the LMA, King LT, and mask ventilation. If intubation through the nose or mouth doesn’t work, a rapid surgical airway will likely be required.

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