thebluntdissection

pulling apart cases from the ED...

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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

bubble of trouble…

December 11, 2016 By Christopher Partyka Leave a Comment

the case.

76 year old male presents to your Emergency Department via ambulance with right hip pain and a fever of 38.1*C.

[Read more…]

Filed Under: #FOAM, Critical care, Infectious Disease, Surgery, Ultrasound Tagged With: nec fasc, necrotising fasciitis, necrotising soft tissue infection, sacral osteomyelitis, subcutaneous emphysema, ultrasound

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

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

eye for an eye…

April 24, 2014 By Christopher Partyka Leave a Comment

the case.

an elderly female arrives to your ED with facial swelling and extensive bruising after a fall where she struck the left-side of her face on a concrete step. She is on warfarin for atrial fibrillation, but has not had her INR tested for the past 3 weeks. [Read more…]

Filed Under: Ophthalmology, Radiology, Surgery, Trauma Tagged With: cantholysis, lateral canthotomy, orbital compartment syndrome

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

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