UOTW #67

27 year old female brought in by ambulance after a high speed MVC. Vitals show a BP of 80 systolic and a heart rate of 140. There is evidence of significant chest trauma. Abdominal FAST is negative for free fluid. A subcostal view shows the following image:


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UOTW #66

This patient presents with skin redness and warmth on his right lateral thigh for 3 days. On exam there is a 4 cm patch of erythema, with a moderate amount of induration. Should this be incised?


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UOTW #65

This 56 year old smoker with a history of HIV and anal cancer presents with complaints of 1 month of gradual onset severe shortness of breath, much worse for the past week. Vitals: 82/46 130 98.6F 30 75%RA.

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UOTW #64

A 73 year old female presents with sudden onset of midsternal chest pain and shortness of breath. The pain is worse with deep respiration and does not radiate. The patient appears to be in severe pain and is diaphoretic.  BP 82/45 P 74 O2 sat 95% RA.

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UOTW #63

78 yo female presents with an ankle injury that was sustained after a fall from standing.

The patient has a history of severe pulmonary hypertension and CHF and is on 4L of nasal oxygen at all times. Orthopedics is requesting a sedation for reduction, but you are reluctant to perform this in the ED due to her significant comorbidities. What nerve block can be done to assist the reduction?
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