**Figure 1.** CXR with thoracic metallic foreign bodies clinically consistent with an intravascular foreign body in both the SVC and IVC crossing the right atria.

Cool County Cases - You Found What Where?: A Discussion of Intravascular Foreign Bodies

September 8, 2023

The Case:

The patient was a 27-year-old male with a past medical history of insulin-dependent type 1 diabetes and prior ICU hospitalization in 2006, presenting with one day of isolated right lower quadrant pain. He endorsed compliance with his insulin. The patient was afebrile with isolated tachycardia to 120 bpm without hypotension or other vital sign abnormalities. His exam was notable for McBurney’s point tenderness and left lower extremity varicose veins. The patient’s blood work was notable for hyperglycemia without ketosis or acidosis in addition to mild leukocytosis. A CT abdomen-pelvis was notable for uncomplicated appendicitis and was incidentally positive for intravascular foreign bodies within the inferior vena cava.

Jose Reyes, MD

PharmD Pearls - Carbapenems & Seizures

September 4, 2023

Formatted by:

Clara Lee, PharmD; PGY1 Pharmacy Resident

Written and Reviewed by:

Joanne C. Routsolias, PharmD, RN, BCPS

**Figure 1.** Anterior dislocation of the shoulder with nondisplaced proximal humeral shaft fracture (arrow).

Ortho Pearls - Shoulder Pain: A Case for Caution

September 1, 2023

While attempting to reduce an anterior shoulder dislocation, a large crack is appreciated. Here, we cover the case of a shoulder dislocation complicated by a concomitant fracture and what this means for the emergency physician.

Garret Prince, MD

the County Consult