No this is wrong ... If the patients has presented as being fit and well previously on no medications then you can never render it as a negative prognosis.... You need to be more optimistic and and find solutions quick and fast ... Although this situation is never real because the patient must ... MUST be on some medications and have some cvs, bleeding, repiratory disorder .... What is the reason for asking such a question anyway OP ..?
He is too unstable to be transferred to x-ray for C-spine views. CXR unremarkable. But since you said please - here is his pelvis x-ray.
Ah fsck - that ain't equal that's some serious shiz
Can I fast bleep the ortho on call? I'm assuming I'm not knowledgable enough to reduce and stabilise this pelvic fracture? Is there an A&E consultant around?!
Yes and no. He needs fluid or he will die. But colloid will dilute his blood, making him bleed quicker. Hence we give him blood instead, but that still dilutes his blood, so we give him plasma (FFP) and platelets to thicken it up a bit.
I don't know if you're a doctor, but that honestly the stupidest doctrine I've ever heard (nothing personal).
I could be a tee-totalling, vegetarian, Olympian, but if I get ****ed up in an car accident, I will get ****ed up in a car accident.
Fair enough your medical history/what shape your body was in before the accident, can determine your recovery/resistance to the injuries, but after a certain point, it cannot compensate for a massive trauma.
(Moreover any recovery/resistance ability must surely be reduced due in no small part to the seniority of his years)
Not being pessimistic (as you seem to think I am), just realistic.
Excellent comment. If it helps, imagine this patient is 18 instead of 78. It makes no difference in the context of this case.
Ah fsck - that ain't equal that's some serious shiz
Can I fast bleep the ortho on call? I'm assuming I'm not knowledgable enough to reduce and stabilise this pelvic fracture? Is there an A&E consultant around?!
We already did that as soon as they came in - but they're still making their way in from home. A&E consultant is at home, but we don't need them. After all, we have an ICU consultant here.
We already did that as soon as they came in - but they're still making their way in from home. A&E consultant is at home, but we don't need them. After all, we have an ICU consultant here.
Oh well in that case.. as a first day f1, let the ICU consultant or the SpR you mentioned earlier take over in the decision making and assist them in any way they ask you.. no?
We already did that as soon as they came in - but they're still making their way in from home. A&E consultant is at home, but we don't need them. After all, we have an ICU consultant here.
I'm assuming I'm missing something else unrelated (carry out further examination?) - but the ?pelvic# is an orthopaedic emergency right?
All I can do is keep fluid resuscitating, taking obs and CPR/etc as necessary
Ahhhhh, well if it's any consolation, at least you know that on your first day you breached patient confidentiality legislation.
(assuming that you weren't trying to fob us off with some google images xray)
There is no patient identifiable information on the x-ray, or in the case study. So no, I didn't know that, and so it doesn't console me. And no, that really is the patient's x-ray, taken around 3 hours ago.
he is too unstable to be transferred to x-ray for c-spine views. Cxr unremarkable. But since you said please - here is his pelvis x-ray.
how can u post a patients pelvis x-ray on a student forum .... That is confidential to the patient ??! Why ask such a question on a forum anyway you should ask your senior ...(registrar) ....?!
There is no patient identifiable information on the x-ray, or in the case study. So no, I didn't know that, and so it doesn't console me. And no, that really is the patient's x-ray, taken around 3 hours ago.
Wow - Critically deconstruct a non serious comment, to remove all and any humour from the situation. Way to kill a joke.