Case by David Branson MD, CNH PEM Fellow A 4  year old previously healthy F presents with concern for ‘eye foreign body.’ The patient reports that a classmate kicked mulch and ‘a splinter flew into her eye.’ A school nurse taped gauze over the eye prior to coming to the ED.  Patient does not answer questions secondary […]

This week’s case highlights a patient with non-verbal autism presenting with difficulty walking. Most learners would start with x-rays but agree that if unremarkable, would likely progress to getting an ultrasound as well. Learners discussed the utility of getting labs prior to imaging results. Given the patient is autistic, there was discussion about holding on […]

Case by Brittany Fitzpatrick MD, CNH PEM Fellow 6 yo F with non-verbal autism who presents with inability to bear weight x 4 days. She is here with her mother, who reports that she started having some difficulty with walking about a week ago and seemed not to want to bear weight on her left […]

This week’s case highlighted a child with lower extremity pain and weakness. Regarding initial imaging, the discussion focused on differentiating between pain and weakness. Weakness would prompt learners to lean more towards CT or MRI, which would provide more information and still include an evaluation of the bones and joint spaces. Urgent sedated MRI brain […]

Case by Gabrielle Jasmin MD, CNH PEM Fellow 8-year-old male with history of eczema presents with RLE weakness. Mom reports that the child was recently seen in an outside hospital’s emergency department 2 weeks prior to presentation for cough and cold symptoms along with right leg calf and hip pain. At that time, he was […]