Admission Diagnosis : The Emergency Room ( Er )

HISTORY OF PRESENT ILLNESS: This 46-year-old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis, presents to the emergency room after having had three days of abdominal pain. It initially started three days ago and was a generalized vague abdominal complaint. Earlier this morning, the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o. earlier around

HISTORY OF PRESENT ILLNESS: This 46-year old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis presents to the emergency room after having had 3 days of abdominal pain. It initially started 3 days ago and was a generalized vague abdominal complaint. Earlier this morning the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o earlier around 6am, but he now

Sakeenah is 14 years old African american girl, she comes to the University of Michigan Pediatric Gastroenterology clinic on 5/22/2018 complaining of abdominal pain. She is accompanied mom and dad today and she provides the interval medical history, She states that the pain started month ago, epigastric, and occasionally radiate to right side, described as squeezing or burning pain. She states that the pain is on/off, in scale of 7-8/10, occur more in the morning. The pain lasts few hours several time a day. She feels that "food sits in my stomach and doesn't digest." Sakeenah states that pain is worse when she eating a grassy food, she stop eating it for a while and the pain seems

There's also other scans such as a ventilation perfusion scan, this looks for blood clots along the pathway to the lungs. Other

This is 35 year old WM. Patient was seen at UAB ED for UTI and kidney stone on 3/30/2016. Patient was discharged with roboxin and ibuprofen. Patient has a history of Hep C, was told about 12 years ago, and was retested at UAB and HVC was positive. Patient is a current resident at the Villige. Patient has a history of substance abuse, denies current use, last use about 10 days ago. Patient is a current tobacco user, denies use of alcohol or illicit drugs. Patient reports some depressive moods, denies thoughts of suicide or

The offender returns to clinic today for a number of issues. 1. Diabetes mellitus type 2: This has been well controlled on oral metformin and the patient reports that she has no concerns in this regard. Last hemoglobin A1c was 5.9 about a month ago and all other labs within normal limits except for a quite high LDL at 171. She has not been on cholesterol-lowering therapy in the past. In addition, her TSH was very slightly elevated at 4.740 which can be considered the upper limit of normal. She has not noticed any significant constipation, excessive fatigue, or cold intolerance but she has had continued trouble with weight gain and thinks she may benefit from some low-dose thyroid replacement. 2. Chronic low back pain: At

Patient is a high school counselor. He participates in physical activities by running 2 to 3 times a week, playing golf, and volunteering at a nursing home. The patient is married with one daughter and one son. He does not use tobacco and periodically drinks at

Blood pressure -138/88, HR 71, Lung sounds –clear, temperature 98.8 F, radial pulse and pedal pulses +1 bi-laterally, normoactive bowel sounds. No history of smoking, drugs, alcohol use or diabetes; takes no daily medications. Surgical history: Hernia surgery September 2016 and cataract surgery September 2013. Moderately active, walks every day, sometime incorporating hand weights. Patient presents with minimal trembling unilaterally, (left side) when fingers stretched out, reports movements have been slower than normal. Patient’s wife reports “He’s been eating more slowly and it has been taking longer for him to get dressed in the morning.”. Upon examination it was determined that patient has reduced arm swing, slight stiffness in neck, difficulty rising from sitting position in the chair, masked facial features and deteriorated balance. No signs or symptoms of stroke.

14 million Canadians visit Emergency Departments (ED) every year, and also reported to having the highest use of EDs (Ontario Hospital Association, 2006). ED overcrowding in Canada has become an epidemic. ED overcrowding has been defined as “a situation in which the demand for emergency services exceeds the ability of an (emergency) department to provide quality care within acceptable time frames” (Ontario Ministry of Health and Long Term Care, 2014). This has been an ongoing problem across Canada. Ontario has developed an initiative to reduce ED wait times by implementing a variety of strategies and collaborating with other institutions. This paper describes the Emergency Room National Ambulatory Intuitive (ERNI), an

Patient Y is a fifty nine year old widow, with a BMI of 29.0kg/m2 (severely overweight). Patient is currently unemployed and lives alone after the passing of her husband in 2008. Patient states that there is a strong family history of heart disease and confirms this by explaining that her father had died at the age of fifty after suffering from chronic heart failure for several years. Patient states that she drinks up to 24 units of alcohol a week and has prevalent past history of smoking.

My perfect academic path seemed set until October of my Second Year. After Reading Days and about two weeks of ignoring severe pain in my abdomen, I finally went to the UVA Emergency Room. After many tests over the course of the night, doctors revealed the unexpected: at nineteen, I had two 18 cm tumors on each of my ovaries. The shock was almost comical at the time; nevertheless, I had major emergent surgery in Norfolk the next morning. I exhibited naivety about the recovery time, but my parents, doctors, and association dean told me the best thing I could do academically was to withdraw from the University. Aside from the five W's on my transcript, there is no record that I was ever at UVA that semester.

tissue can be removed and examined, or an x-ray to examine for pulmonary edema, fluid

The following case scenario is based on a fictitious patient, and it would be use on this paper as a guidance to develop a patient and family teaching plan. The situation: Mrs. Marquez, a 39-year-old Caucasian female was admitted into the Emergency Department due to complains of shortness of breath and anxiety. Patient cannot take deep breaths, appears overweight and denies Allergies to medication. The background: Patient has medical history for panic attacks, atrial fibrillation, and Grand Mal seizures; however, patient is not constantly taking her seizure medication. Patient previously had a cholecystectomy, and smokes 1 pack of cigarettes per day for 12 years. The Assessment: Patient vital signs 98.8° F oral, 109 heart rate, 26 respiratory rate, 150/86 blood pressure, SaO2 97% on room air. Denies pain. Neurological; Patient is 65 inches tall, weighing 246 lbs. She is able to move all extremities with strong pushes and pulls. States her “last seizure was two months ago.” Respiratory; Respirations are even, deep, and rapid. Lungs are clear on auscultation. Cardiac; EKG reveals atrial fibrillation; patient states, “It feels like my heart is racing at times.” Pulses are palpable +3 all extremities; capillary refill is instant. GI; Abdomen soft, no distended, and no tender with bowel sounds present in all four quadrants; skin is intact and warm. Current medications: Dilantin 400mg PO BID, Lexapro 20mg PO daily, Metoprolol 25

A: Janie is a 60 year old Female with PMH of A-Fib, COPD, Hypothyroidism, HTN, Lung Cancer and recently diagnosed Pulmonary Embolism. Janie presents to ER for evaluation on SOB, cough with greenish sputum, sore thoart, hoarseness and generalized weakness. Janie lives at home with her husband, use to smoke ½ pack per week, but quit many years ago, denies alcohol or drugs. Family history is non-contributory. Allergies: NKDA. Differential diagnosis includes worsening Lung Ca, PE, COPD and CHF. Janie uses home O2 at 4 L/NC. V/S: T=98.7, HR=89, R=16, B/P=132/56, O2 sats=100% on 4L/NC, Pain=6/10. Labs: WBC=7.6, H&H=8.5/27, Na=141, Troponin=0.08/0.06, BNP=495, INR=4.2, UA=3+ protein, 1+ blood and 6-10 RBC. CXR: Impression:1). COPD with nonspecific coarsening of the basilar interstitium. 2). Mild cardiomegaly with borderline cardiac compensation. 3). Right

L.V. is a 51-year-old Hispanic female. She is 5’4 height and 150 lbs. Patient denies pain, discomfort, or chest pain during physical assessment. Patient is allergic to Aspirin she states that she gets rashes when she takes it. She was diagnosed with thyroid cancer 5 years ago and got her thyroid glands surgically removed. Patient denies the use of tobacco and drinks 2-3 beers on special occasions. Patient works for an American Restaurant as a server, she’s been serving for over ten years. Patient states that she’ll be getting her first colonoscopy next month and she just recently got her yearly mammogram done and results were normal. Immunizations are up to date and she gets the flu shot every year. Patient has four daughters and has been happily married for 20 years. Patient denies using glasses or contacts she visits her optometrist every year and has never had a problem with her vision.