Of EMed (6)

summary of today (a&e is giving me blogger's diarrhoea!)

1) hepatic flap. my first. jaundiced patient with a history of alcoholic liver cirrhosis, came in for a fall at home. he was totally zonked out, so likely stage 1 or 2 hepatic encephalopathy. he even has inversed sleep patterns! wow.

2) posterior dislocation and elbow dislocation. not in the same patient of course, but two patients who came in at the same time. stayed with the elbow dislocation, who's a judoka in junior college. took him some time to be sedated, and even then he was able to tap the mo's hand pretty firmly when the mo was reducing it, all the while with his eyes half open. haha. i love watching reductions with the accompanying "conscious sedation". m&rs are such wonderful things - simple but very effective. and the conscious sedations make the patients so loopy that it's really hilarious to watch. (i'm starting to sound pretty unsympathetic am i?) but nothing can beat watching a kid come out of ketamine haze. heh.

3) trauma team activation. pretty standard - drunk tourist knocked down by lorry, but it was the details of the activation that got me thinking. shan't elaborate too much here because they aren't pleasant stuff.

off day tomorrow. time to tie up loose ends for the overseas elective, and to attend care group. i miss it.