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Tongue biting and seizure
It’s a routine Wednesday morning in the ED. An ambulance carries a 25 year old male patient with loss of consciousness lasted for 2–4 min, giddiness, and dimness of vision. The patient had these symptoms while he was at home, alone. The patient reports that he probably regained from his loss of consciousness after few…
Where is peritonitis?
A 80 YO man with a history of hypertension presents to the ED complaining of abdominal pain. He felt well until 8 hours ago, when he developed diffuse abdominal pain. The patient is afebrile, tachicardic, BP is 180/100 his lungs are clear, ECG shows no changes suggestive of ischemia. There is diffuse abdominal rigidity. In…
Run to the operation room!
A 70 yo woman is brought to the ED by ambulance. She’s suffering from vomit, lach of flatus and abdominal pain since 24 hours says the nurse. She’s pale, the abdomen shows a midline scar. There is diffused tenderness with rebound. Abdomen US and X rays show abnormal distended loop of small bowel. Ok,…
My heart hates Christmas
It’s 7 pm on Christmas day, a 32 yo woman refers palpitations since the morning. I was with my frends yesterday nigth, I think I had drank a bit too much. I Hate Christmas, it brings me down. She’s awake, alert and oriented, her mood is low. Vital signs are normal, EKG shows a sinus…
NO fever, NO bacteriaemia?
A 80 yo nursing home resident woman is brought to the ED by ambulance. “Hypothension, cough and a hystory of heart failure ”, refers the nurse. She looks pale and confused, her respiratory rate is 22, oxygen saturation on room air is 90%. Ear temperature is 36,5°C, BP is 90/60 mmHg, HR is…
Is my hand broken?
A 24 y/o guy presents in ED with the left hand upraised. “I fell off my bike yesterday – he says – I remember a serious impact with an outstreched palm.” There aren’t wounds, he feels pain on the radial side of left wrist, there is an anatomical snuffbox tenderness. The clamp sign is…