thebluntdissection

pulling apart cases from the ED...

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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

against better judgement…

August 27, 2014 By Christopher Partyka Leave a Comment

the case.

a 62 year old female is bought into your ED following a high-speed MVA. She has driven her car into telegraph pole at ~ 80km/hr. [Read more…]

Filed Under: Radiology, Trauma Tagged With: aortic dissection, blunt aortic injury, deceleration injury, mediastinal widening, traumatic aortic dissection

don’t jump the gun…

July 22, 2014 By Christopher Partyka Leave a Comment

the case.

an elderly male is bought to ED following a high-speed motor vehicle accident having driven his car into a tree at ~100 km/h. He is complaining of severe chest pain & trouble breathing. [Read more…]

Filed Under: Interesting, Trauma, Ultrasound Tagged With: EFAST, false positive, lung ultrasound, pneumothorax

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

a whack to the flank….

March 25, 2014 By Christopher Partyka Leave a Comment

the case.

an 84 year old man is bought to your emergency department following a 3 metre fall from a ladder. He has landed on his right-hand side & is complaining of severe bilateral chest & flank pain. [Read more…]

Filed Under: Trauma, Ultrasound Tagged With: haematuria, renal haematoma, renal injury grading, renal laceration, renal trauma

no retreat, no reversal…

August 29, 2013 By Christopher Partyka Leave a Comment

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…]

Filed Under: #FOAM, Evidence, Interesting, Surgery, Trauma Tagged With: aPTT, bleeding, dabigatran, dabigatran reversal, direct thrombin inhibitor, Factor VII, FEIBA, haemorrhage, haemothorax, thrombin time

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