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Is it always necessary to perform an arterial blood gas after a blunt trauma?

A 53 year old man is involved in a motor vehicle crash. He refers a moderate thorax and abdominal pain. No head injury, the helmet is not broken, the patient remembers the accident. Systolic blood pression is 120/80 mmHg, respiratory rate is 24, saturation is 100%, he has abrasions over the torso and right thorax…

ByCiro Paolillo10 June 20130Comments

Bones and joints Ultrasound

Septic Arthritis and Arthrocentesis

A 33 y/o male comes to the ED for fever, knee swelling and pain. He has a history of joint surgery because of trauma, and prothesis, dating 4 years before. He is HIV positive He presents feverish (38°C), the left knee is swollen and hot. WBC 34.000/μL, CRP 109 mg/L, PCT 0,05 ng/mL. As we…

ByIlenia Spallino26 January 20120Comments

Abdomen

Intestinal Ischemia and Lactate

A 84 y/o woman comes accompained by relatives for abdominal pain. She is oriented and cooperative, she suffers pain (NRS 10/10). Abdomen is treatable, but very painful in the lower quadrants, you see green watering diarrhea, she has not fever. Abdominal Radiograph shows air/fluid levels WBC: 35000/μl PCR: 22 mg/L Lactate: 1,7 Can you rule…

ByIlenia Spallino23 November 20110Comments

The Emergency Physician