This week we highlight the case of a child who had a toothbrush impaled in the oropharynx. The crux of the decision centered around sedation for imaging with a potentially unstable oropharyngeal injury. It is important to note that though the patient was currently stable in this case, he had a high potential to be […]
Hot Seat #218: A Brush With Danger
Case by Mickey Emmanuel, CNH PEM Fellow A 3-year-old boy with no significant past medical history comes to the ED today with a toothbrush impaled in the oropharynx. Mom did not witness the event but did note that he was jumping up and down on the bed while brushing his teeth. She believes he fell […]
Hot Seat #217: A Caustic Conundrum
Case by Hannah Kotler MD, CNH PEM Fellow You are carrying the transport phone when you receive a call for a destination decision: 15-year-old M ingested “half a bottle” of household bleach in a suicide attempt. Currently, he is c/o stomach and throat pain. His vital signs are as follows: HR 80, BP 118/78, SpO2 […]
Hot Seat #216: Dazed and Confused
Case by Erin Thomas MD, INOVA PEM Fellow 13-year-old transgender male with history of asthma, MDD, GAD, PTSD, h/o SI who presents with a seizure-like episode at school. He had 1 minute of witnessed convulsive seizure activity. Per mom, he was his normal self this morning. All medications were kept under lock and key at […]
Hot Seat #215: Anaphylax-yes…or no?
Case by Jessica Hippolyte MD, CNMC PEM Fellow 8 y.o. F with seasonal and food allergies presents with 3 days of intermittent facial swelling, hives, and abdominal pain after peanut exposure. She has known food allergies to wheat, peanuts, and shellfish. 3 days ago, patient developed tongue and lip swelling and abdominal pain 1 hour […]