Background: Foreign body (FB) impaction in the oropharyngeal region-and specifically the tongue-is a common problem in the emergency department that often requires specialty consultation and admission for operative intervention. Over the years, the use of point of care ultrasound (POCUS) has increased ease and success of FB removal in other anatomic regions, but is only rarely reported for extraction of FB from the tongue outside of the operating room.
Case Report: This case demonstrates a unique case of ultrasound-guided removal of a fishbone from the tongue in the emergency department after blind attempts failed.
Although sore throat is a very common complaint in the emergency department and is often associated with benign conditions, such as pharyngitis, it can be the early onset of something much more serious and even life threatening. A thorough history and examination are vital to the correct diagnosis but a high index of suspicion must be maintained to diagnose less common but serious pathology, such as epiglottitis and retropharyngeal abscess. Airway management is paramount to survival, and aggressive means should be taken early when epiglottitis is considered.
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November 2012
Evaluation of the nonpregnant patient presenting to the emergency department with vaginal bleeding requires the emergency physician to be aware of the potential for a variety of underlying causes. Patients with vaginal bleeding may have non-life-threatening problems such as fibroids, endometriosis, or treatable sexually transmitted diseases such as gonorrhea and chlamydial infection. However, care must be taken to differentiate these from more serious causes of pelvic pain and bleeding such as ectopic pregnancy, hemorrhagic cyst, ovarian torsion, and rare complications from fibroids such as intraperitoneal hemorrhage.
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