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Chest X-Ray and aortic dissection

A 70 yo man come to the ED for restrosternal chest pain and shortness of breath during minimal activity in the last days. He is an ex smoker, with a history of hypertension. On physical examination the patient is not in distress, with a regular blood pressure and regular oximetry. ECG shows no evidence of…

ByCiro Paolillo28 June 20120Comments

Chest

How LR works. Why any test is unnecessary for a patient with very low-risk chest pain?

A 40 yo truck driver, presented in ED with substernal chest pain. He is healthy, no family history of CAD. Held for observation, serial ECG have not modified, not elevated troponin. Is an Exercise Treadmill Testing useful (ETT)? Or a Myocardial Perfusion Imaging (MPI) is better? The pretest probability of CAD in this…

ByCiro Paolillo1 May 20120Comments

Chest Ultrasound

Diagnosis of pneumonia. Is it the time for a combined imaging strategy?

A 80 yo man is brought from an assisted-living facility because of fever, productive cough, tachycardia and dyspnoea. He has a history of dementia and hypertension. He is cachectic, you hear ronchi on the left side. How should you approach this patient? In the Emergency department setting the pretest probability of pneumonia…

ByCiro Paolillo5 April 20120Comments

Chest

Acute Dyspnoea and Laboratory

I t’s a dark night when a red code arrive at the ED by ambulance. Paramedics tell you: “called for acute dyspnoea, I think it’s a COPD exacerbation, he is wheezing, I gave him bronchodilators and steroids, but he is worsening”. He has a history of COPD and hypertension. He presents sweaty, dyspneic,…

ByIlenia Spallino5 November 20110Comments

Chest Ultrasound

Acute dyspnoea and Lung Ultrasound

It's a dark night when a red code arrive at the ED by ambulance. Paramedics tell you: “called for acute dyspnoea, I think it’s a COPD exacerbation, he is wheezing, I gave him bronchodilators and steroids, but he is worsening”. He has a history of COPD and hypertension. He presents sweaty, dyspneic, arterial…

ByIlenia Spallino31 October 20110Comments

Chest

Acute dyspnoea and X-Ray

I t's a dark night when a red code arrive at the ED by ambulance. Paramedics tell you: “called for acute dyspnoea, I think it’s a COPD exacerbation, he is wheezing, I gave him bronchodilators and steroids, but he is worsening”. He has a history of COPD and hypertension. He presents sweaty, dyspneic,…

ByIlenia Spallino18 October 20110Comments

Chest

Acute dyspnoea and clinical findings

I t's a dark night when a red code arrive at the ED by ambulance. Paramedics tell you: “called for acute dyspnoea, I think it’s a COPD exacerbation, he is wheezing, I gave him bronchodilators and steroids, but he is worsening”. He has a history of COPD and hypertension. He presents sweaty, dyspneic, arterial pressure…

ByIlenia Spallino5 October 20110Comments

Chest

D-dimer and Aortic dissection

It’s 3.00 am when a 55 yo man is accompained to the ED by his wife because of sudden onset precordial pain, he has not clinical history, he does not smoke and he has an active life style, you find a normal blood pressure and clinical examination and a normal ECG, but the pain is…

ByIlenia Spallino17 May 20110Comments

The Emergency Physician

Chest X-Ray and aortic dissection

How LR works. Why any test is unnecessary for a patient with very low-risk chest pain?

Diagnosis of pneumonia. Is it the time for a combined imaging strategy?

Acute Dyspnoea and Laboratory

Acute dyspnoea and Lung Ultrasound

Acute dyspnoea and X-Ray

Acute dyspnoea and clinical findings

D-dimer and Aortic dissection

Septic Arthritis

Septic Arthritis and Arthrocentesis

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