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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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Rapid IJ (aka Easy Internal Jugular Cannulation)

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martes, 25 de marzo de 2014

Trauma renal

thebluntdissection

MARCH 25, 2014 - BY CHRIS PARTYKA

"The case.
An 84 year old man is bought to your emergency department following a 3 metre fall from a ladder. He has landed on his right-hand side & is complaining of severe bilateral chest & flank pain.
His systolic blood pressure with the paramedics has been 100-105 mmHg, except for a transient episode of hypotension [72mmHg systolic] which resolved after a 300mL bolus of crystalloid. On arrival to ED he has a GCS of 15, full recollections of events & no focal neurological deficit but is in excruciating pain.
Pulse 66/min. BP 106/72. SaO2 94%. RR 26.
He is on warfarin for atrial fibrillation, but does not recall his last INR measurement."
  • What are your principles of management in this case ?
  • What happens next ??
  • Here is his CT scan...
  • The diagnosis ??
  • References.
http://thebluntdissection.org/2014/03/a-whack-to-the-flank/