Depressed skull fracture

735.1i - head trauma - skull fracture
735.2 - head trauma - skull fracture 2

A 31-year-old male presented to the ER after falling from a 3-meter wall. He fell on his face and is complaining of face pain and body aches. He isn’t sure if he lost consciousness. GCS 15/15. Not much history was taken from the patient as he was in excruciating pain. Vitals HR: 105 bpm, RR: 19 bpm, BP: 106/59, Ox. Sat: 100%, Temp: 36.9.

This case is a kind of unusual. Having this amount of depression of the skull and showing almost no neurological abnormality is not happening very frequent.

We hope that you also recognized the air inside in the right image.

To learn more about how to read the CT scan, see the chapter below.

How to read head CT by Reza Akhavan

You may also see below infographic showing a mnemonic about reading head CT in the ED.

56-years-old male presented with chest pain.

716 - perforated ulcer

56 years old male known case of HTN, presented to ED with chest pain. The onset was 2 hours ago started gradually. It is a constant and worsening pain. Location: Anterior central chest epigastric. Radiating to Central back” middle of the back.” The character of the pain is heaviness and tightness. The degree at onset was 3 /10. The degree at maximum was 6 /10. The Exacerbating factor is leaning forward. The relieving factor is rest but not leaning forward, eating, antacids, oxygen, nitroglycerin, and morphine sulfate.

Do you recognize the problem in the chest x-ray?

To learn about management, please read chapter below.

Perforated Viscus by Ozlem Dikme

41 new clinical images

41 new clinical images are added just now. The archive now has 752 photos/videos. You can also download and use them freely in your presentations, exams or self-study. Click here to reach clinical image/video archive.

Thank you! – Clinical Image Archive Reached 28.000 views

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Swallowed Coin

In case you didn’t encounter a 6-year-old patient who swallowed a coin today!

696 - Foreign body ingestion

iEM Education Project Team uploads many clinical picture and videos to the Flickr and YouTube. These images are free to use in education. You can also support this global EM education initiative by providing your resources. Sharing is caring!

AMS and right side weakness

In case you didn’t encounter acute altered mental status and right side weakness today!

690.1 - Figure 6a. CT - Left basal ganglia infarct

iEM Education Project Team uploads many clinical picture and videos to the Flickr and YouTube. These images are free to use in education. You can also support this global EM education initiative by providing your resources. Sharing is caring!

From Experts To Our Students! – Clinical Decision Tools

Clinical Decision Rules chapter written by Stacey Chamberlain from USA is just uploaded to the Website!

What is the name of this fracture?

In case you didn’t encounter a trauma patient today!

674.4 - C1 fx

iEM Education Project Team uploads many clinical picture and videos to the Flickr and YouTube. These images are free to use in education. You can also support this global EM education initiative by providing your resources. Sharing is caring!

What is wrong with this CT?

In case you didn’t encounter shortness of breath today!

iEM Education Project Team uploads many clinical picture and videos to the Flickr and YouTube. These images are free to use in education. You can also support this global EM education initiative by providing your resources. Sharing is caring!

A 69-year-old male with altered mental status

In case you didn’t encounter an elderly with altered mental status today!

631.1 - subdural

A 69-year-old male was brought to the ED by EMS because of altered mental status described by relatives. He hardly communicates and is not oriented. He has a motor weakness on the left upper and lower extremities 2 and 3 out of 5, respectively. BP: 183/88 mmHg. Other vitals are in normal range. CT scan image is given. What is next?

iEM Education Project Team uploads many clinical picture and videos to the Flickr and YouTube. These images are free to use in education. You can also support this global EM education initiative by providing your resources. Sharing is caring!

From experts to our students! – eFAST

Unilateral or bilateral?

644 - C-spine dislocation

In case you didn’t encounter another trauma today!

You are working in a rural hospital. A 55-year-old female was brought to the ED by EMS. She was found at home, lying on the ground, in front of the stairs. She is vitally stable but unconscious (GCS: E1, V:2, M:3). You applied trauma surveys. After inline stabilization, you intubated the patient. The facility does not have a CT scan, and you order standard X-ray series for trauma including c-spine.

What are abnormal findings in this x-ray?

Facet dislocation? Unilateral or Bilateral?

iEM Education Project Team uploads many clinical picture and videos to the Flickr and YouTube. These images are free to use in education. You can also support this global EM education initiative by providing your resources. Sharing is caring!

Sudden Severe Headache

665-  SAH

In case you didn’t encounter a sudden severe headache today!

A 46-year-old female patient presented with severe headache. BP: 178/88 mmHg, HR: 103 bpm, RR: 22/min, T: 37, SpO2: 98% in room air. She has no history of disease. She is unconscious (GCS E1, V3, M4). No obvious lateralized motor deficit. Bedside gluco-check is normal. You intubated her to secure airway and send her to the CT (above image). What is your next action?

iEM Education Project Team uploads many clinical picture and videos to the Flickr and YouTube. These images are free to use in education. You can also support this global EM education initiative by providing your resources. Sharing is caring!

Selected Imaging Modalities

628.14 - acetabular fx 2

eFAST

by Ashley Bean and Gregory R. Snead Introduction The objective of the extended focused assessment for sonography in trauma (eFAST) is to detect free fluid

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PoCUS – RUSH Protocol

by Rasha Buhumaid Why use POCUS in undifferentiated hypotension? Hypotension is a high-risk sign which is associated with increased morbidity and mortality rate. The differential

Read More »

BLUE protocol

by Toh Hong Chuen Case Presentation A 68-year-old man with a history of congestive cardiac failure (CCF) and chronic obstructive pulmonary disease (COPD) presented with breathlessness

Read More »

How to Read C-Spine X-Ray

by Dejvid Ahmetović and Gregor Prosen Introduction C-spine x-ray interpretation is one of the fundamental skills of emergency physicians. Although current guidelines lead us to

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How to read chest x-rays

by  Ozlem Koksal Introduction Chest X-ray interpretation is one of the fundamental skills of every doctor. Emergency physicians are particularly exposed to various chest x-rays

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How to read head CT

by Reza Akhavan For a standard approach to read head/brain computed tomography (CT) scan, one should adhere to systematic algorithms. The predefined algorithms are various,

Read More »

How to read pelvic x-rays

by Sara Nikolić and Gregor Prosen Introduction Pelvic fractures carry life‐threatening injury potential which should be identified or suspect during the primary assessment of patients with

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Pelvic X-ray interpretation

628.6 - Figure 6 - sacroiliac and symphysis pubis joints

How to read pelvic x-rays chapter written by Sara Nikolić and Gregor Prosen from Slovenia is just uploaded to the Website!