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/