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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

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

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

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

Mind the gap…

June 3, 2014 By Christopher Partyka Leave a Comment

the case.

a 29-year old female with a past history of anorexia nervosa, polycystic ovarian syndrome, chronic back pain and analgesic abuse presents to the Emergency Department.  She describes 3 days of bilateral ankle and facial swelling.  She tells you that she has been taking ‘lots of painkillers’ for her back pain. [Read more…]

Filed Under: #FOAM, Acid-Base, Metabolic, Renal Tagged With: acid base, metabolic acidosis, non-anion gap acidosis, renal tubular acidosis, urinary anion gap

biochemical bugaboo…

December 6, 2013 By Christopher Partyka Leave a Comment

the case.

a 62 year old female presents to ED with breathlessness & chest pain. [Read more…]

Filed Under: #FOAM, Endocrine, Interesting, Metabolic Tagged With: hypercalcaemia, hyperparathyroidism, hypophosphataemia, multiple myeloma, thiazide

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