Tamingthesru
A Pain in My Heart - Curated Comments and Expert Commentary
Thanks to everybody who chimed in on our last "Flight"! We had a great discussion on the management of the STEMI transfer patient. These aren't just "milk runs" as pointed out by Dr. Hinckley. The highlights of the discussion are below with additional commentary on the case by Dr. Bill Hinckley and Air Care Resident Assistant Medical Director Dr. Matt Chinn. Out final flight will be lifting off June 1 and it's a doozy - looking forward to the discussion!
Pediatric Abdominal Ultrasound
After a long shift in the adult ED, jam packed with patients presenting with abdominal pain, your looking forward to a brand new day in the Peds ED. Your first patient, however, gives you PTSD-like flashbacks to the previous days shift.
Alice is a 8 year old girl who developed abdominal pain last night. Her parents thought that she would be okay waiting until morning, that the pain would pass in the night. On waking this morning, however, the pain was still there.
CT Abdomen and Pelvis - Hollow Viscus
It's weird how you get runs of patients in the ED. Some days it seems like it's nothing but wall-to-wall low risk chest pain, altered mental status, or back pain. Today (and a lot of other days), it's abdominal pain. Scanning the board you see seemingly nothing but Level 3 acuity patients with the chief complain of "Abdominal pain." Out of the scores of patient's, you seen so far, the last 2 worry you the most:
Andrea is a very pleasant 20 year old student from a local college. She came in after having symptoms of right lower quadrant pain over the course of the past 8-12 hours. She didn't recall any migratory symptoms but does endorse a lack of appetite, nauseousness, 2 episodes of vomiting (started after the pain), and steadily worsening pain.