This weeks case highlights the challenges of clinically clearing a c-spine vs. radiographic findings. We discussed the utility of a c-collar in a toddler when you are not concerned about an unstable cervical spine injury. We also discussed the challenges of having CT information from an outside hospital in a patient you may not have […]
Hot Seat #262: A “collarly” debate
Case by Kate Ritter, CNH PEM Fellow You get a call about a trauma transfer from OSH. Patient is a 22-month-old male who was sitting in the front seat of a non-electric bike going 20 mph on a gravel trail (dad was pedaling), patient’s foot got caught in the front wheel and both patient and dad flew off bike. Patient has a “non-displaced mandibular fracture” […]
Hot Seat #261 Denouement
This weeks case highlights the challenges of interpreting an abnormal neurology exam. We discussed the inconsistencies in her exam that are not correlated with a specific neurologic pathway, however absent reflexes are never normal. We went over a wide differential and the importance of baseline NIFS. MRI completed which showed non-specific white matter lesion in […]
Hot Seat #261: A wobbly situation
Case by Sarah Benett, CNH PEM Fellow 15-year-old female with a history of ADHD, anxiety, and depression presented with acute bilateral lower extremity weakness. On the morning of presentation, she awoke around 8 AM and was unable to walk to the bathroom, requiring her to drag herself across the floor. Since onset, she reported inability to […]
Hot Seat #260 Denouement
This weeks case highlights the challenges of interpret abnormal labs results in patients without systemic symptoms and abnormal VS (BPs). We also discussed how the disposition for these patient’s can be different based on clinical assessment and comfort a with outpatient follow-up. During his 48 hour stay, blood pressures have overall been stable and below the 95th percentile requiring no […]