Collapse and recruit
A 19 year old male is admitted after a severe traumatic brain injury. Due to refractory intracranial hypertension he is intubated and receiving 20mg an hour of morphine, 20mg an hour of midazolam and 200mg an hour of propofol.
Rapid descent
A 30 year old male presents with a 3 day history of fevers and increasing breathlessness. On presentation he is noted to be severely hypoxic with sats of 80% on room air. The following chest X-ray is obtained:
A Case of CO2 Narcosis
A 67 year old gentleman with a BMI of 45 was waiting for his respiratory outpatient clinic appointment. While waiting, he fell asleep. A medical emergency was called because he could not be woken up.
Ballooning Up
A 36 year-old immunosuppressed male was infected with swine-origin influenza virus requiring mechanical ventilation. Overnight the inspiratory pressures needed to maintain his tidal volume had progressively increased and his face had become markedly swollen.
Pulmonary panic
A 17 year old female with a background history of HIV presents with a 3 day history of fevers, chills and rigors. Her admission chest X-rays are shown below:
Pneumonia gone bad
Consider a 56 year old male with no past medical history presenting with 10 days of fevers, chills, myalgia and cough followed by worsening breathlessness over the past 4 days.
Roast duck and juniper beer
Consider a 73 year old female admitted with vomiting and subsequent chest pain. This is her admission chest X-ray.
Not just a PE
A classic respiratory case. This 25 year old female presented with worsening breathless. She has no previous medical problems.
Not just pneumonia
A 30 year-old male presented with 24 hours of worsening respiratory distress, following a 5-day prodrome of cough, fever, diarrhoea, lethargy and malaise.
How to prevent diarrhea when hiking
Drinking surface water while hiking through the wilderness exposes you to gastrointestinal infections. A significant amount of education about this has been directed at decontamination of the water.
TEE Essentials: Assessment of the left atrium and appendage
TEE Left atrium - mid-esophageal LAA view assess left atrial appendage, quantify emptying velocities, thrombus/spontaneous contrast.
Pott fracture
Archaic eponym: Effectively a fracture-dislocation of the ankle, involving a fracture of the fibula, disruption of the deltoid ligaments with an intact tibiofibular ligament