Cases coming soon!

1. A 52-year-old woman with a complex past medical history presents to the ED for altered mental status and seizure-like activity. During her hospitalization, she has several cardiac arrests. 2. A 64-year-old man presents with multiple self-inflicted stab wounds, shock, and a possible history of ingestion. He is taken emergently to the operating room, where he develops persistent metabolic acidosis and has a brief cardiac arrest. 3. A 40-year-old male bodybuilder with a history of palpitations presents to the ED in respiratory distress with tachycardia, hypertension, tachypnea, and hypoxia.

1. A 70-year-old man with schizoaffective disorder and a recent viral illness presents to the ED from an assisted living facility with garbled speech, hypotension, and hypothermia. 2. An 80-year-old man with a history of alcoholic cirrhosis admitted for ascites has been on a flumazenil infusion for two weeks. He becomes sedated whenever the infusion is turned off. 3. A 49-year-old woman with a past medical history of schizophrenia presents to the ED with foot pain and altered mental status after recently being discharged from the hospital. Over the next 24 hours she becomes progressively more altered and nonverbal.

1. A 52-year-old man experiences cardiac arrest after an accident at a chemical plant. ROSC was obtained by EMS. He presents to the ED intubated and in a wide-complex tachycardia. 2. A 55-year-old man with a history of OUD, COPD, presents to ED in opioid withdrawal (COWS 17). Last use of opioid was 1 day earlier. He receives buprenorphine 32 mg over four hours. The patient becomes increasingly hypoxic throughout the night and is intubated for presumed pneumonia. 3. An 8-year-old boy presents after receiving “dipirona monoidratada” drops by his grandmother for fever. He is now complaining of abdominal pain.

1. A 41-year-old woman presents with progressive leg swelling and a long-standing history of burning leg pain. 2. A 30-year old woman with nonverbal autism presents with 2 hours of recurrent syncope. 3. A 73-year-old man presents to the ED unresponsive following an intentional overdose of clonazepam. He is not protecting his airway, but he is DNR/DNI and family wants to respect his wishes.

1. A 22-year-old man with a history of ADHD and mood disorder has a seizure at home after taking extra quantities of his antidepressant with the intent to get high. An ECG on ED arrival reveals the following: HR, 150 bpm; QRS, 105 ms; QT, 290 ms; QTc, 375 ms. 2. A 30-year old-man is "found down" with a suspected opioid overdose. A fentanyl screen in the ED is positive and a finger stick glucose reads ‘low.’ 3. ​A 77-year-old man drinks an unknown liquid from a sports drink bottle found in his garage and shortly thereafter experiences intractable vomiting. A point of care test done in the ED reveals the likely diagnosis.

1. A 55-year-old woman presents with persistent nausea, vomiting, and diarrhea after taking a weight loss supplement that she purchased online. She arrives to the ED with the following vital signs: HR 73, BP 135/75, RR 24, SaO2 98% RA. Shortly after, her HR begins to drop into the 40s. 2. A 42-year-old man with a history of pituitary macroadenoma excision complicated by CSF leak returns to the ED five days later with encephalopathy and oliguric renal failure. 3. A 24-year-old man with a history of Crohn’s disease, depression, hypertension, and erectile dysfunction comes to the ED with sweating, tremors, “muscle tightening”, rapid heart rate (130s) starting 1-1/2 h after using a tanning product.

1. A 22-year-old, 32-week pregnant woman presents to the ED after an intentional ingestion of an insecticide called "Sniper." Her initial vital signs are: BP, 126/78 mmHg; HR, 96/min; RR, 26/min; T, 98.9F; O2 Sat, 98% (RA). She has increased salivation per the treating physician. 2. A 16-year-old girl presents with a presumed pseudoephedrine overdose. Her vital signs are HR 137, BP 198/158, RR 30, T 36.7. After an observation period of 5 days she has not improved. 3. A 39-year-old man is transferred from a treatment center to the ED for opioid withdrawal and intractable vomiting Several hours after arrival at the treatment center that morning, he developed worsening opioid withdrawal for which he received methadone (30mg) but immediately vomited and became "shaky." His initial vital signs are: BP, 153/95 mmHg; P, 83/min; RR, 22/min; T, 99 F; Sp02, 96%

1. A 7-day-old boy in the NICU is receiving TPN and dopamine through a left forearm peripheral IV that is noted to have extravasated. This is suspected to have begun two 2 hours earlier. 2. A 30-year-old man is cleaning his saltwater tank when "something" gets in his eye. Four hours later he develops a fever, cough, and shortness of breath. 3. A 38-year-old woman on INH monotherapy for latent TB presents with RUQ abdominal pain. She is noted to have: AST 545, ALT 130, AlkPhos 156, nl bilirubin. A RUQ sonogram is negative.

1. A 56-year-old man with a history of diabetes, hypertension, severe restrictive lung disease secondary to covid pneumonia presents with one day of fatigue, dyspnea on exertion, dry cough, and hypoxia (79% at home pulse oximetry). Patient states the symptoms began acutely, two hours after getting home from work the day prior. He reports that a few other co-workers have similar symptoms as him or they have nausea, abdominal pain, vomiting. He thinks a virus is going around his workplace. 2. A 51-year-old man presents with a diffuse rash over the past 6 days that developed after he ingested a product for sexual stimulation called “royal honey” that he obtained at a local shop. His VS are normal and he is in no distress. 3. A 2-year-old girl is extracted from underneath debris from a structural fire; she was found covered in soot and is pulseless. CPR is initiated and ROSCis achieved within minutes. She arrives to the ED with the following vital signs: BP, 95/58; HR, 130; RR, 28; SaO2, 100% on NRB; T, 98.6F. She is only responsive to pain and is promptly intubated.