This patient presents with initial presentation of local erythema, warmth, swelling concerning for cellulitis. Sensitivity/pain to light touch around the erythematous area. No lymphangitic spread visible and no fluid pockets or fluctuance concerning for abscess noted. Low concern for osteomyelitis or DVT. No immune compromise, bullae, pain out of proportion, or rapid progression concerning for necrotizing fasciitis. Patient to be discharged home with keflex with follow up with their PMD.
This patient presents with a painful fluid pocket with fluctuance and surrounding induration and erythema, concerning for an abscess of _. The abscess was anesthetized with lidocaine and then I&D was performed with deloculation and purulence was expressed. There is no lymphangitic spread visible. Low concern for osteomyelitis. Patient is not immunocompromised, and there is no bullae, pain out of proportion, or rapid progression concerning for necrotizing fasciitis. Patient to be discharged home with bactrim and keflex with follow up with their PMD.
Presentation most consistent with diabetic foot infection. Given History, Exam, and Workup can not rule out underlying osteomyelitis_, however have low suspicion for Necrotizing Fasciitis, Abscess, DVT. Patient with no signs of sepsis. Patient given empiric vanc, cipro, flagyl_.
This patient who presents with rash for _, consistent with _.  History and exam findings not consistent with dangerous etiologies of rash such as SJS/TEN, or secondary dangerous causes such as petechial rashes from thrombocytopenia or rickettsial infections. Rash does not appear urticarial with no signs of anaphylaxis either. Plan at this time is to treat symptomatically, instruct to follow up with PCP or derm PRN.
This patient presents with symptoms consistent with acute hypersensitivity reaction, likely acute allergic reaction. Presentation not consistent with acute anaphylaxis (lack of pulmonary, dermatologic, cardiovascular or GI symptoms, lack of hypotension or exposure to known allergen), angioedema, serum sickness (no recent drug exposure, lacks fevers, arthralgias). No evidence of airway compromise or shock at this time. Patient improved with H1/H2 blockers, steroids. No need for epinephrine. Prescribed patient EpiPen Rx, and patient to keep food diary, and to follow up with PMD for allergy testing.
Wound inspected under direct bright light with good visualization.  Area with linear laceration across soft tissue through adipose without exposure of muscle belly or tendon_.  No overt foreign body.  Area hemostatic.  Neurovascular exam congruent with above.  Area extensively irrigated with sterile normal saline under pressure.  Laceration repaired in simple fashion as below (please see procedure note for further details)_.  Patient tolerated procedure well and neurovascular exam intact and unchanged post repair with intact distal pulses and cap refill_.  Cautious return precautions discussed w/ full understanding.  Wound care discussed.  Prompt follow up with primary care physician discussed and return for suture removal in _ days.
MDM for different chief complaints
Critical care documentation
Combative patient
Wilderness preparedness
ACEP clinical policies
Expedited partner therapy
SCVMC:CUSTODY CARE
FALLS protocol