the case.
46 year old male is bought into your resuscitation bay by local ambulance following a three metre fall from a work platform onto a horizontal metal railing below.
two in two days…
I have recently prepared a lecture on a current, yet still controversial topic for work following exposure to these two interesting cases. Here are the cases & their discussion as well as the slide-show attached…
[Read more…]the steak is stuck…
the case.
a 36 year old male presents to your ED at 2am with retrosternal pain and concern that last nights steak “got stuck and didn’t go down”. He has vomited once and now continues to spit out saliva as he feels he cannot swallow anything. Despite this, he is not particularly distressed and looks well. [Read more…]
no retreat, no reversal…
the case.
a 79 year old female returns to ED with left sided chest pain & dyspnoea. She was recently admitted following a fall with rib fractures (including a flail segment) and a small haemothorax. [Read more…]
concerning extension…
the case.
You receive a BAT call about a 31 year-old male who has come off his bicycle after running into a stationary car at ~30 km/hour. Bystanders report that he was thrown 3-5m and had a loss of consciousness of ~3 minutes without witnessed seizure activity. [Read more…]
headache for all…
The Case.
A 28 year old female presents to your ED at 2am. She left the hospital 12 hours earlier with her newborn first child who is now 2 and half days old. Her main complaint is that of profound lethargy, fatigue, severe worsening bifrontal headache and breathlessness.
She is normally fit and well, takes no regular medications & has no significant past medical history. Her pregnancy was uneventful, but her delivery (at 39 weeks) was slightly hair-raising with foetal distress & decelerations due to an obstructive labour (requiring a ventouse).
She looks lethargic and is laying quietly in bed, but is speaking in full sentences. Her observations are within normal limits, but her BP catches your eye at 154/89. Her cardiorespiratory exam is unremarkable (specifically, her chest is clear, there are no murmurs & I cannot see a JVP). Her belly is soft with a palpable uterus, midway between umbilicus & pubic symphysis. She has no peripheral oedema. Her GCS is 15 with reactive pupils and normal cranial nerves. She has impressively brisk reflexes (you don’t need your tendon hammer) and her power/tone/sensation appear symmetrical & normal.
Her bloods are completely normal! (FBC, LFTs, PLTs, even the CRP) !!
Now what ??