thebluntdissection

pulling apart cases from the ED...

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pupils predict pathology…

March 16, 2014 By Christopher Partyka Leave a Comment

the case.

A 34 year old male is bought to your ED with reduced level of consciousness. He was at a restaurant having dinner with family & friends when he excused himself to use the bathroom. They found him 15 minutes later slumped near the toilet – unconscious and barely breathing. [Read more…]

Filed Under: #FOAM, Neurology, Radiology Tagged With: coma, pin point pupils, pontine, Pontine haemorrhage, primary pontine haemorrhage

the unveiling…

January 13, 2014 By Christopher Partyka Leave a Comment

the case.

a 64 year old female presents to your Emergency Department at midnight with acute severe abdominal pain. [Read more…]

Filed Under: #FOAM, Gastroenterology, Interesting, Radiology, Surgery

back with a vengeance…

December 27, 2013 By Christopher Partyka Leave a Comment

the case.

a 59 year old male presents to ED at 2am with a two week history of progressive back pain. He is worried because it is worsening in severity and now radiates to the left flank & left-lower quadrant. [Read more…]

Filed Under: #FOAM, Infectious Disease, Interesting, Radiology Tagged With: Aortitis, back pain and fever, mycotic aneurysm, salmonella

straightening the spiral…

September 28, 2013 By Christopher Partyka Leave a Comment

the case.

a 2 year old male is carried into your ED screaming. He is horribly distressed and trying to reach down to grab at his right thigh. His parents report that he was standing outside watching his older brother ride his bike. He was knocked over in the process and his right leg ‘twisted around’ in the process. [Read more…]

Filed Under: Orthopaedics, Paediatrics, Radiology Tagged With: femoral nerve block, fracture management, midshaft femur, non-accidental injury, paediatric femur fracture, Pavlik Harness, pediatric femur fracture, Spica cast, spiral fracture

concerning extension…

July 30, 2013 By Christopher Partyka Leave a Comment

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…]

Filed Under: #FOAM, Evidence, Interesting, Radiology, Spine, Trauma Tagged With: blunt vertebral artery injury, cervical spine fracture, CT angiography, foramen transversarium, posterior circulation stroke, screening, Trauma, Vertebral artery dissection

a knackered neonate…

July 20, 2013 By Christopher Partyka Leave a Comment

the case.

You are working in a district hospital and are called to the Special-Care Nursery to assist with an unwell newborn infant.

She was born 2 hours ago at 39 + 4 weeks gestation, to a primip mother who reports a completely unremarkable pregnancy and normal antenatal investigations (including morphology scans). The child has had marked respiratory distress and hypoxia since birth… [Read more…]

Filed Under: Airway, Anaesthesia/Analgesia, Paediatrics, Radiology Tagged With: airway, CCAM, DOPE mnemonic, foetal lung interstitial tumour, neonatal intubation, neonatal resuscitation, respiratory distress, RSI

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