altIt 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

altA 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.

altA 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.

altThis 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.

altA 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.

altThe 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.
Visual Dx
edited by Mark Silverberg, MD
A point-counterpoint discussion of relevant research 
altThis neck swelling could be anything. What one question will help narrow your differential?
Test approved for sepsis risk stratification in the ICU with ED usage sure to follow 

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