thebluntdissection

pulling apart cases from the ED...

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an abominable airway…

March 16, 2017 By Christopher Partyka Leave a Comment

the case.

a 28 year old male presents to your Emergency Department with a 2-3 week history of increasing neck swelling. He is now spitting out frank purulent discharge from his mouth and reports fevers and night sweats.

[Read more…]

Filed Under: #FOAM, Airway, Interesting, Metabolic Tagged With: airway, bougie, cric, cricothyroidotomy, open cricothyroidotomy, primary surgical airway, scalpel, surgical airway, surgical cricothyroidotomy

shrouded shock…

February 28, 2017 By Christopher Partyka Leave a Comment

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.

[Read more…]

Filed Under: #FOAM, Cardiology, Critical care, ECG, ECHO, Evidence, Interesting, Trauma, Ultrasound Tagged With: BCI, blunt cardiac injury, cardiac contusion, chest trauma, ECG, ECHO, myocardial contusion, RBBB, shock, thoracic trauma, Trauma, troponin

another bubble of trouble…

January 3, 2017 By Christopher Partyka Leave a Comment

the case.

43 year old female is brought into your resuscitation bay by the paramedics.  She has a 2 day history of vomiting and diarrhoea on the background of type 2 diabetes and alcohol abuse.  Her son is concerned that she has become increasingly confused despite drinking her usual amount of alcohol.

[Read more…]

Filed Under: #FOAM, Acid-Base, Critical care, Infectious Disease, Interesting, Metabolic, Surgery Tagged With: emphysematous pyelonephritis, gas forming organisms, HAGMA, lactate, pyelonephritis

collective crises…

November 10, 2016 By Christopher Partyka Leave a Comment

the case.

a 28 year old female is brought into your resuscitation bay by paramedic crews following a two day history of nausea and vomiting. As she rolls past, you notice that she is distressed with pain, looks clinically very dry and is quite drowsy.

[Read more…]

Filed Under: #FOAM, Endocrine, Interesting, Surgery Tagged With: Addison's, adrenal crisis, adrenal insufficiency, hernia, hyperkalaemia, lactate, small bowel obstruction, steroids, umbilical hernia

an insidious intruder…

September 25, 2016 By Christopher Partyka Leave a Comment

the case.

28 year old male presents to your tertiary emergency department with chest pain, exertional dyspnoea and left calf pain. [Read more…]

Filed Under: #FOAM, Acid-Base, Cardiology, ECHO, Interesting, Metabolic Tagged With: anticoagulation, cardiomyopathy, ECHO, echocardiography, embolisation, left ventricular thrombus, LV thrombus, mural thrombus, POCUS

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

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Recent Posts

  • an abominable airway…
  • shrouded shock…
  • another bubble of trouble…
  • bubble of trouble…
  • collective crises…

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