Mark’s Story

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Nurses Edition Commentary

Kathy Garvin, RN and Lisa Chavez, RN
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Shanna J., MD -

Hi, after listening to Mark's story from Dec EMRAP, I recognized a similar presentation in a 6 year old boy. He presented for six days of fever and nasal congestion with cough. That morning he developed right calf pain and refused to walk prompting parents to bring him into the ED. Initial evaluation in our ED demonstrated R OM and an elevated WBC with normal CK and negative Flu Swab. On re-evaluation, he felt better with fluids and motrin, but his calf was still exquisitely tender, but normal to inspection. Joint exam was also completely normal. I wanted to obtain a CT or MRI to further evaluate his symptoms so we had to transfer him out of our community ED. Initial perspectives were that I was over reacting and a peds ortho consult agreed to mri, but to evaluate for osteomyelitis. He ended up in the OR the next day with peds ortho for an I & D as his MRI did demonstrate myofasciitis with an abscess. Cultures grew Strep.

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A Pancreas and a Testicle Walk Into a Bar... Full episode audio for MD edition 264:51 min - 369 MB - M4AEM:RAP 2017 December Canadian Edition Canadian 33:30 min - 46 MB - MP3EM:RAP 2017 December Aussie Edition Australian 26:36 min - 37 MB - MP3EM:RAP 2017 December Spanish Edition Español 79:15 min - 109 MB - MP3EM:RAP 2017 December German Edition Deutsche 105:44 min - 145 MB - MP3EM:RAP 2017 December French Edition Français 24:47 min - 34 MB - MP3EMRAP_2017_12_December_Vol.17_Summary 1 MB - PDFEM:RAP 2017 December Board Review Answers 95 KB - PDFEM:RAP 2017 December Board Review Questions 312 KB - PDFEM:RAP 2017 December Individual MP3 Files 334 MB - ZIPEM:RAP 2017 December Individual Summary Files 2 MB - ZIPEM:RAP 2017 - December Spanish Written 1 MB - PDF

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