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Ilenia Spallino

28 articles published Follow:

News

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…

ByIlenia Spallino25 December 20140Comments

Head

Is a cold steak enough in black eye?

A young guy comes to the ED after a car crash. While he was driving, the car in front of him stopped abruptly so they crashed. Fortunately speed was low and he does not report major trauma, but a black eye due to an impact towards the airbag. You promptly evaluate his sight and find…

ByIlenia Spallino28 June 20140Comments

Bones and joints

Ottawa ankle rules. Does it really work?

A 16 yo guy is brought in ED by his mother after a scholar accident. While he was running, he crashed. My son has a sore ankle! Is it broken? Asks the mother seriously worried. The ankle his slightly tumefied, there isn’t bone tenderness at the posterior edge or tips of either malleolus,…

ByIlenia Spallino11 April 20140Comments

Bones and joints

Does every shoulder pain means magnetic risonance?

A 35 y/o male come to the ED because of pain in his right shoulder, he refers the pain started some month ago during a tennis match, the pain continued but it wasn't so high so he kept playing in the last months, now it is worse. "My tennis mate told me I should perform…

ByIlenia Spallino9 February 20140Comments

Abdomen

Alarm symptoms and gastric cancer. Are they alarms or they are alarming?

It’s a busy Monday morning in ED. A doctor at the phone – calls the nurse – there’s a primary care physician. Hi – says a voice on the other side – I’m in a patient’s home. He’s a 40 yo man with dyspepsia, his wife refers weight loss of about 10…

ByIlenia Spallino24 January 20140Comments

Abdomen

Age of 45 and dyspepsia

It’s the begining of another night shift in ED. Rik, an agreable young colleague approximates: Hi- he says – I have just seen a 60 y/o man who refers epigastric pain since 2 days. He denies bleeding and weight loss, he isn’t anemic. The bedside US shows a normal gallbladder and a normal abdominal aorta,…

ByIlenia Spallino11 January 20140Comments

Abdomen

Plain X ray in suspected bowel obstruction. Is that all?

A 67 y/o woman arrives in the ED at 5pm because of diffused abdominal pain since 2 hours. She has nausea and she refers costipation from the day before. She has a history of hysterectomy 5 years before because of fibroma. Vital signs are normal, she presents pale and sufferer for pain, the abdomen…

ByIlenia Spallino11 November 20130Comments

Head

Headache and Subarachnoid haemorrage. How and how long your pain started?

A young healthy man presents to the ED because of acute onset severe headheache. The pain has started the day before while he was swimming, he refers the worst headache of his life, neurological examination and vital signs are all normal. Head CT is also normal. After therapy and short clinical observation he feels better,…

ByIlenia Spallino11 July 20130Comments

Bones and joints

Sciatica: only pain control, or imaging? Point your big toe to your nose!!!

A 50 y/o friend of yours called for you. He refers low back pain radiating to his left leg from approximately 2 weeks. “help me doc - he says - I have a sciatica, a dog is biting my buttock, can you favor me with an urgent RMN?”. He is very suffering. During the straight…

ByIlenia Spallino11 July 20130Comments

Blood

To fill or not to fill? Try to raise the legs…

A 54 y/o man is brought to the ED because his wife has found him semiunconscious in the morning, he has not significant clincal history and does not take medicaments, he presents hypoperfused, arterial pressure is 90/50 and MAP is 63, lactate is 7 mmol/L and hemoglobin is 14 g/dl. Inferior vena cava diameter is…

ByIlenia Spallino2 April 20130Comments

The Emergency Physician

Ilenia Spallino

My heart hates Christmas

Is a cold steak enough in black eye?

Ottawa ankle rules. Does it really work?

Does every shoulder pain means magnetic risonance?

Alarm symptoms and gastric cancer. Are they alarms or they are alarming?

Age of 45 and dyspepsia

Plain X ray in suspected bowel obstruction. Is that all?

Headache and Subarachnoid haemorrage. How and how long your pain started?

Sciatica: only pain control, or imaging? Point your big toe to your nose!!!

To fill or not to fill? Try to raise the legs…

Septic Arthritis

Septic Arthritis and Arthrocentesis

Is cervical spine X-ray necessary if there is a distracting injury?