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.
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