thebluntdissection

pulling apart cases from the ED...

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Emergency Doc; interested in ultrasound, retrieval & medical education ( #FOAMed )

a perplexing paradox…

June 21, 2016 By Christopher Partyka Leave a Comment

The case.

a 70 year old female is bought to your ED at 10pm via ambulance with a dense right-sided hemiparesis following a witnessed collapse at home only 30 minutes earlier. [Read more…]

Filed Under: #FOAM, Interesting, Neurology, Radiology, Respiratory Tagged With: ischaemic stroke, massive PE, massive pulmonary embolism, MCA stroke, paradoxical embolism, patent foramen ovale, PFO, pulmonary embolism, thrombolysis

twist and shout….

May 6, 2015 By Christopher Partyka Leave a Comment

the case.

34 year old female presents to ED with a 2 day history of worsening left-sided pleuritic chest pain associated with shortness of breath. There has been no associated cough, fever or sputum production.

She is one week post-Caesarian section; an uncomplicated, elective procedure from which she has recovered well.

[Read more…]

Filed Under: #FOAM, Interesting, Surgery Tagged With: pleuritic chest pain, Post-Partum, splenic infarction, splenic torsion, wandering spleen

Mind the gap #2…

April 9, 2015 By Christopher Partyka Leave a Comment

the case.

a 43 year old male presents to your ED with a three day history of severe epigastric pain and recurrent vomiting. He has now become increasingly breathless and is complaining of severe retrosternal chest pain.

[Read more…]

Filed Under: #FOAM, Acid-Base, Interesting, Metabolic Tagged With: acid base, Delta gap, Delta ratio, HAGMA, High anion gap, hyperchloraemic acidosis, metabolic acidosis, NAGMA

a splitting headache…

March 23, 2015 By Christopher Partyka Leave a Comment

the case.

39 year old female presents to your Emergency Department with a four day history of a gradually worsening headache. Whilst she has a past history of migraines, this headache is much more severe and of different character to any migraine she has had previously. [Read more…]

Filed Under: #FOAM, Interesting, Neurology, Radiology Tagged With: anticoagulation, cerebral venous thrombosis, CT venogram, CVT, delta sign, dural sinus thrombosis, empty delta sign, headache, sagittal sinus thrombosis, secondary headache, stroke unit, thrombolysis

a covert combination…

September 11, 2014 By Christopher Partyka Leave a Comment

the case.

72 year old male presents to your Emergency Department with a 4-5 hour history of palpitations. He appears well and has no associated symptoms.

[Read more…]

Filed Under: #FOAM, Cardiology, ECG, Interesting Tagged With: AICD, atrial fibrillation, defibrillator, double tachycardia, ventricular tachycardia

against better judgement…

August 27, 2014 By Christopher Partyka Leave a Comment

the case.

a 62 year old female is bought into your ED following a high-speed MVA. She has driven her car into telegraph pole at ~ 80km/hr. [Read more…]

Filed Under: Radiology, Trauma Tagged With: aortic dissection, blunt aortic injury, deceleration injury, mediastinal widening, traumatic aortic dissection

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