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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…

ByCiro Paolillo24 October 20140Comments

Chest

PCT and pneumonia: worth it?

A 78 yo woman is brought from an assisted-living facility because of dyspnea and fever. She has an history of dyabetes and heart failure. She is confused, tachipnoic, tachicardic and febrile with rales on the back. Chest X ray shows an infiltrate. PCT value is 1,5 µg/L. Does PCT provide prognostic information concerning mortality…

ByCiro Paolillo11 May 20130Comments

Chest Ultrasound

Is chest X ray necessary to rule out PNX after thoracic maneuvers?

I t’s a busy day in ED this morning. The first patient refers dyspnoea, he has an advanced pulmonary neoplasia, ultrasound and chest x-ray confirm that the left zone is occupated by a pleural effusion. The thoracentesis removes about 1.5 liter of fluid, the patient breathes easily. The second patient is 65 yo, he…

ByCiro Paolillo4 February 20130Comments

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

The Emergency Physician

NO fever, NO bacteriaemia?

PCT and pneumonia: worth it?

Is chest X ray necessary to rule out PNX after thoracic maneuvers?

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

Septic Arthritis

Septic Arthritis and Arthrocentesis

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