- Dental Pain
- Hemoptysis
- Red Eye
- Sore Throat
Dental Pain
- Differentials
- Atraumatic
- Odontogenic
- Pulpitis
- Pericoronitis
- Periradicular periodontitis
- Post-extraction pain
- Alveolar Osteitis
- Periodontal
- Periapical abscess
- Periodontal abscess
- Acute necrotizing ulcerative
- Gingivitis
- Ludwig’s Angina
- Odontogenic
- Traumatic
- Fracture
- Subluxation
- Avulsion
- Atraumatic
- History
- Trauma?
- Consider fractures,subluxation, avulsion
- Hot/cold sensitivity?
- Suggests exposed dentin
- Recent dental procedures?
- Consider dry socket, incomplete extractions, abscess
- Fever/chills?
- Suggests infectious causes
- Trauma?
- Physical Exam
- Head trauma?
- Consider injuries to several teeth and/or other facial structures
- Neck swelling?
- Consider ludwig’s angina
- Gingival swelling?
- Consider periapical abscess
- Head trauma?
- Work-Up
- Imaging
- CT Maxillofacial w/ IV contrast
- Imaging
*Deep Dive: Common Dental Emergencies (AAFP)
Hemoptysis
- Differentials
- Airway Disease
- Bronchitis/Bronchiectasis
- Neoplasm
- Trauma
- Foreign Body
- Infectious
- Tuberculosis
- Pneumonia
- Fungal Infection
- Vascular Disease
- Pulmonary Embolism
- AV Malformation
- Pulmonary Hypertension
- Vasculitis
- Other
- Coagulopathy
- Valvular Heart Disease
- Cocaine
- Airway Disease
- History
- Hemoptysis or hematemesis?
- Differentiate between pulmonary and GI pathology
- Scant, frank, or massive?
- Differentials vary based on amount of blood
- Immunosuppression?
- Consider tuberculosis
- Sedentary?
- Consider pulmonary embolism
- Smoking history?
- Consider lung cancer or chronic bronchitis
- Hemoptysis or hematemesis?
- Physical Exam
- Asymmetrical lung sounds?
- May help identify source of bleeding
- HEENT exam
- Identify other potential sources of bleeding
- Lymphadenopathy
- Suggests malignancy as source
- Signs of DVT?
- Suggests pulmonary embolism
- Asymmetrical lung sounds?
- Work-up
- Labs
- CBC, aPTT, INR
- Imaging
- CXR
- Chest CT
- Labs
*Deep Dive: Hemoptysis (emDocs)
Red Eye
- Differentials
- Painful
- Ruptured globe
- Corneal ulcer
- Corneal abrasion
- Acute angle closure glaucoma
- Painless
- Conjunctivitis
- Subjunctival hemorrhage
- Hyphema
- Extra-ocular
- Blepharitis
- Hordeolm
- Orbital/periorbital cellulitis
- Cavernous sinus thrombosis
- Cluster headache
- Painful
- History
- Foreign Body sensation?
- Consider corneal foreign body/abrasion
- Sick Contacts?
- Consider conjunctivitis
- Discharge? If so, watery or purulent?
- Consider infectious causes
- Exposure to metal or wood working?
- Consider foreign body
- Foreign Body sensation?
- Physical Exam
- External rash
- Suggests orbital or periorbital cellulitis
- Painful EOM
- Suggests scleritis or cellulitis
- Elevated Intraocular pressure
- Consider glaucoma
- Discharge
- Consider conjunctivitis
- Hutchinson sig908
- Consider herpes ophthalmicus
- External rash
- Work-Up
- Fluorescein
- If suspect corneal ulcer or abrasion
- Tonometry
- If suspect increased intraocular pressure
- CT Orbit
- If suspect ruptured globe or corneal laceration
- Fluorescein
*Deep Dive: The Red Eye (Core EM)
Sore Throat
- Differentials
- Infectious
- Peritonsillar abscess/Cellulitis
- Retropharyngeal/Parapharyngeal abscess
- Epiglottitis
- Strep pharyngitis
- Mononucleosis
- Viral pharyngitis
- Ludwig’s angina
- Diphtheria
- Noninfectious
- Caustic ingestion
- Foreign body
- Acute coronary syndrome
- Lymphoma
- Oropharyngeal tumor
- Infectious
- History
- Voice changes?
- Consider peritonsillar abscess
- Drooling?
- Consider deep space neck infection
- Recent weight changes/fatigue?
- Consider cancer
- Sexual history?
- Consider gonococcal infection
- Sick contacts?
- Consider strep pharyngitis, viral pharyngitis, or mononucleosis
- Voice changes?
- Physical Exam
- Respiratory distress?
- Consider need for airway intervention
- Uvula deviation?
- Suggests peritonsillar abscess
- Abnormal lung sounds?
- Consider lower respiratory tract infection
- Stridor, drooling, sniffing position?
- Consider airway obstruction
- Rashes or lesions?
- Consider strep or diphtheria
- Respiratory distress?
- Work-Up
- Labs
- CBC, BMP
- Rapid strep test (if Centor score = 3)
- Throat culture (if rapid strep negative)
- Gonorrhea/chlamydia (if recurrent; not improving)
- Imaging
- Lateral neck X-ray
- CT neck w/ IV contrast
- Labs
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