CAUTION: THESE NOTES CONTAIN SPOILERS!!!

Case Introduction

A notorious, disheveled frequent flyer presents to your emergency department for her back pain and is asking for more Dilaudid…

Initial Vitals

* Temp 99.0* HR 99* RR 18* BP 118/78* O2 99%

Critical Actions

* Ask about Red Flags for Spinal Infection* Perform a Thorough Spinal Exam* Obtain MRI Spine with Contrast* Initiate Broad Spectrum Antibiotics* Treat Pain when Pathology Identified

Final Diagnosis

Spinal Epidural Abscess

Tips and Tricks

Don’t let consultants or other members of your team talk you out of appropriate management of a patient

Additional Reading

* Basic approach to Back Pain (EM Clerkship)* Epidural Abscess Overview (AAFP Website)