Items tagged “emergency”

Abnormal testicular Doppler flow (arterial, venous, or both) can be a differential challenge. Always remember that the patient's presenting history helps quite a bit in narrowing the differential. Reduced flow partial testicular torsion (<360 degrees) venous outflow is obstructed first, resul...

Pyogenic flexor tenosynovitis is a serious infection of the flexor tendon sheath of a finger that can lead to devastating consequences if delayed 1,2. With the early diagnosis and treatment of pyogenic flexor tenosynovitis, the serious sequelae of infection are markedly decreased. In a large ser...

Pericardiocentesis is a procedure that can be performed to withdraw pericardial fluid as a therapeutic intervention or a diagnostic modality. Indications diagnostic pericardial effusion of an unknown etiology therapeutic relief of pericardial tamponade Contraindications absolute none (gi...

The stroke volume (SV) is referred to as the volume of blood ejected into the aorta or main pulmonary artery during each cardiac cycle. The stroke volume index (SVI) is the stroke volume corrected for the body surface area (BSA). Usage The stroke volume is another integral parameter used for t...

Fecal impaction is the inability to spontaneously evacuate solid feces. It is common in the elderly population. A severe form of fecal impaction is often referred to as a fecaloma.  Terminology Fecal loading is a poorly defined term but generally refers to the volume of fecal material in the c...

Splenic volvulus (rare plural: volvuli) also called splenic torsion may be seen as a complication of a wandering spleen due to weakness of the splenic ligaments 1. Clinical presentation abdominal pain: mild to severe in intensity which depends on the degree of torsion 4-6 abdominal mass 5 ab...

Hematemesis is the vomiting of blood, it is an indication of upper gastrointestinal bleeding. Mortality is generally near to 10% 1,2,4. Please see the main article on upper gastrointestinal bleeding for more detail.  Treatment and prognosis In patients with moderate to severe hematemesis, life...

Mitral annulus disjunction (MAD) is an anatomic abnormality involving the confluence of the left atrium, mitral valve annulus, and the base of the left ventricle. It is classically associated with the spectrum of myxomatous disease of the mitral valve and mitral valve prolapse (MVP).  Epidemiol...

The Lindegaard ratio refers to the calculated ratio of the mean flow velocities in the middle cerebral artery and the ipsilateral extracranial internal carotid artery, as measured by transcranial Doppler 1. Its primary utility is, in the context of increased MCA velocities after subarachnoid hem...

Pericapsular nerve group (PENG) blocks are one approach for delivering anesthesia to the hip joint. It is most commonly used in patients with fractures of the hip and bony pelvis 1.  Indications acetabular fractures 5 pubic rami fractures proximal femoral fractures intertrochanteric fractur...

Wrist arthrocentesis refers to the aspiration of an effusion in the radiocarpal joint. It serves primarily as a diagnostic modality to determine fluid composition, and may function secondarily to reduce pain associated with capsular stretch. The dynamic, ultrasound-guided technique will be descr...

Takotsubo cardiomyopathy, alternatively Takotsubo syndrome, is a primary acquired cardiomyopathy characterized by transient left ventricular dysfunction. Several sets of diagnostic criteria exist and are variably utile in various clinical and research settings. International Takotsubo Diagnosti...

A supraclavicular brachial plexus block is indicated for establishing sensory and motor blockade of the upper extremity, including the humerus, elbow, forearm, wrist and hand.  Indications necessity to provide analgesia of the upper extremity for: abscess incision and drainage elbow dislocat...

Platypnoea-orthodeoxia syndrome refers to the concomitant occurrence of dyspnea and hypoxemia, respectively, which are precipitated by assuming an upright position and alleviated by assuming a recumbent position 4. Clinical presentation As the name of the syndrome suggests, the hallmark clinic...

An esophageal balloon tamponade device is a form of balloon catheter designed to exert direct pressure on bleeding gastro-esophageal varices in order to obtain hemostasis. It is considered a temporizing measure in hemodynamically unstable patients in whom endoscopic (or angiographic) interventio...

Acute exogenous lipoid pneumonia is an uncommon form of exogenous lipoid pneumonia and is typically caused by the aerosolization and aspiration of a highly viscous hydrocarbon, such as vegetable oil, mineral oil or petroleum jelly 5. The more common pulmonary toxicity exerted by hydrocarbons is ...