Patient has an AC separation grade ___ and will be discharged home. There is no skin tenting and distal neurovascular exams are appropriate. Patient has currently been stabilized in the emergency department. Patient has been given a sling to wear. Patient understands that they may require outpatient surgery. Patient’s symptoms not typical for other emergent … More AC Separation MDM

Pulseless Electrical Activity in ICU HPI:___ for whom a Code Blue was called for cardiopulmonary resuscitation. Per available history at this time, the patient became pulseless and apneic while in the ICU as initially noted by bedside nursing staff. Down-time prior to ACLS was initiated by ICU staff is unknown. ROS: not performed because the … More Code Blue Note

PNES / Pseudoseizure MDMLast reviewed: March 2026 Contents MDM Templates Psychogenic Nonepileptic Spells (PNES) Clinical Education Approach to Suspected PNES Distinguishing Features Communicating the Diagnosis Disposition References MDM Templates Psychogenic Nonepileptic Spells (PNES) Patient presents with observed shaking/jerking movements. Multiple features on exam inconsistent with epileptic seizure activity: preserved responsiveness during movements, forceful eye closure, … More PNES/pseudoseizure MDM

Contrast Nephropathy OK to scan: Cr  < 2.0 mg/dL and/or eGFR > 40 Risk factors to suspect need for Cr prior to scan: metformin use, age> 60, HTN, DM, gout, chemotherapy. In non-emergent settings, patients without these risk factors can get a scan without labs and patients with some just require a Cr within last … More Physician Override Guides

ICD/Pacemaker Problems ICD/Pacemaker Problems MDM Last reviewed: March 2026 Contents MDM Templates ICD/Pacemaker — Early Complication ICD/Pacemaker — Late Complication ICD Shocks — Appropriate and Inappropriate Pacemaker Malfunction Clinical Education Device Basics and NBG Code Failure to Pace Failure to Capture Failure to Sense Magnet Behavior Electrical Storm Pacemaker-Mediated Tachycardia Modified Sgarbossa Criteria with Paced … More ICD Problems MDM

Laceration MDM Last reviewed: March 2026Contents MDM Templates Simple Laceration Facial Laceration Scalp Laceration Tongue / Intraoral Laceration Procedure Notes Suture Repair Staple Repair Clinical Education Suture Selection by Location Suture Material Properties Suture Removal Timeline Anesthesia Pearls Wound Closure Timing Antibiotics in Lacerations High-Risk Wounds Tongue Laceration Pearls References MDM Templates Simple Laceration Patient … More Laceration MDM

Pulmonary Embolism & Pulmonary Hypertension: ED Management Pulmonary Embolism & Pulmonary Hypertension MDM Last reviewed: March 2026 Contents MDM Templates Pulmonary Embolism — Non-Massive Pulmonary Embolism — Submassive (RV Strain) Pulmonary Embolism — Massive (Hemodynamic Compromise) Pulmonary Hypertension / RV Failure Exacerbation Clinical Education PE Risk Stratification & Clinical Decision Tools Anticoagulation Regimens Thrombolytic Therapy … More PE and Pulmonary HTN MDM

Extremities : The ___ ankle is swollen and tender in the [anterior lateral ankle] There is [no] posterior malleolar tenderness There is [no] tenderness of the base of the fifth metatarsal, the navicular, or other bones of the foot. The patient [is] able to take weight bearing steps. The compartments of the foot and leg … More Ankle Sprain Exam

an injury of the ___ ankle which occurred [just prior to arrival]. The mechanism of injury was [twisting after tripping]. Patient [was] able to ambulate since the event. Pain is rated as ___ out of 10. Pain quality is characterized as [aching] in nature. Symptoms are worse with touching or moving, and better with rest. … More Ankle Sprain HPI

presents complaining of skin redness for ___ days. Patient complains of redness to the lower extremity. Patient states that the skin color change is getting worse. Pain is described as moderate in nature and worse with movement. Denies recent purulence, penetrating trauma. Patient ___ does have history of the same. No fever.   No IV … More Cellulitis HPI