Stuff You Need, In Your Pocket
HAPPY HOLIDAYS. This holiday season, give the gift of safety. Meant for the lay public, Don’t Try This At Home and Think Twice: More Lessons From the ER are entertaining, hilarious and full of sage advice on how to avoid ending up as a patient in the ED. Your family and friends will love them. For even more safety advice, have friends & family check out the safety tips at GotSafety.ORG
Parents come to the ER with their fully vaccinated 8 month old who has had fever and rash for 4 days. They saw the pediatrician yesterday in the office. He told them it looked like the fever and conjunctivitis were probably from adenovirus. Desetin was recommended for the diaper rash. Today they say he is more irritable and the rash looks worse. The child has URI symptoms, but no GI symptoms. On exam he is calm in mom’s lap with normal vital signs except for a temperature of 101.2. His exam is normal except for the findings shown in the images below.
What is the differential diagnosis? What should you do next?
Sorry, something non-mysterious again this month. If you want a mystery though, case 25 is up, but you’ll have to wait till December for the answer.
We all learned how to do a physical exam in med school, PA school, nursing school, etc., but most of us have learned our own little “tricks” along the way that increase the speed, sensitivity or palatability of our exams. Here are some of my favorites. Please submit your own in the comment section below.
Spine Palpation: Most people use their fingertips. Instead…
Lung Auscultation: Save the $300 for an electric stethoscope. It’s much more useful to …
Cardiac Auscultation: Ask your patient to stick out their tongue. This does two things…
Knee Effuision: To sensitively check for a knee effusion have the patient …
FOR COMPLETIONS OF TRICKS, CLICK HERE.
DON’T FORGET TO SUBMIT YOUR OWN EXAM TRICKS IN THE COMMENTS SECTION
If anyone is interested in some end-of-year CME in Los Angeles please check out the Cedars-Sinai 5th Annual Emergency Medicine Symposium December 7th. There are some excellent physicians lecturing. Don’t worry, you won’t have to listen to any of my hot air.
For more information please contact Barbara Stokes: stokes@cshs.org or (310)423-2935
ER Nurses Week was October 7th-13th. If you forgot to show your appreciation it’s not too late for belated gifts. Order medical pocketbooks as gifts. Until October 19th, for every 4 books you order we’ll throw in a 5th book free! That’s 20% off. Don’t people appreciate a belated gift almost as much as an on-time one?
Instead of a case this month I have a number of questions regarding odd medical observations. Interstingly most have something to do with the eye. Please share your own body oddities with your colleagues. Just submit a “comment” below or at the end of the answer page. For the answer page, click the link below.
Question 1: Using your ophthalmoscope you notice that not only is the exam amazingly easy, but that the retina is a beautiful patchwork of blues and greens with red arteries and a white optic disc. What condition does your patient have?
Question 2: How can you see the arterial ramifications of your own retina?
Question 3: How can you use your hands alone to see clearly underwater, as if you had a mask?
