Case no2
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An 85-year-old male underwent a two-stage revision of a total hip replacement. During the second stage, he experienced significant blood loss from the femoral end requiring multiple blood transfusions and vasoactive drug support. His condition deteriorated and he became unresponsive, with elevated ST segments on EKG and died despite resuscitation efforts. He had previously documented in an advance directive his desire not to be resuscitated and to allow natural death if no reasonable expectation of recovery existed.
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please comment
thank u
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Confirm a death (medical information) -how to confirm a death ??
it is necessary to confirm a death even without a minute chances of doubt. world wide we have noticed several cases that showing being lived after death confirmation . it is important to a medical professional for a successful confirmation of death , basic terms are explained below .
please comment
thank u
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A presentation to help new pediatric transplant nurses manage the post-operative kidney transplant patientCase 2
This is a case study of a 40-year-old Thai female patient with a history of rheumatic heart disease who had undergone aortic and mitral valve replacements 10 years prior. She presented with heavy menstrual bleeding and was admitted for further workup and a planned dilation and curettage procedure. Due to her mechanical heart valves, special precautions were needed with managing her anticoagulation in preparation for the procedure. Post-operatively, she developed bleeding complications and cardiogenic shock, which unfortunately led to her death. The case highlights the risks and appropriate management of anticoagulation for patients with mechanical heart valves undergoing other medical procedures.
Cholecytectomy
An 80-year-old woman presented with right upper abdominal pain and nausea/vomiting. She had a history of hypertension, hypothyroidism, obstructive sleep apnea, and recurrent urinary tract infections. Examination and investigations revealed acute obstructive cholecystitis. She underwent an open cholecystectomy with combined spinal-epidural anesthesia and was managed post-operatively with epidural analgesia and intravenous fluids. She recovered well and was discharged on the third post-operative day.
Mortality Meet Presentation 3 by Dr. Saumya Agarwal
Mortality Meet Presentation 3 by Dr. Saumya Agarwal Central Institute of Orthopaedics, Safdarjang Hospital and VMMC, New Delhi
A 64-year-old male farmer presented with right hip pain after a fall. He had a history of right hemiplegia and hypertension. Examination revealed tenderness and limited range of motion of the right hip. Investigations showed anemia. He was admitted for skin traction and surgery. The night before surgery, he developed respiratory distress. His condition deteriorated and he suffered cardiopulmonary arrest. Resuscitation efforts were unsuccessful and he was declared dead due to a suspected pulmonary thromboembolism.Mortality Meet Presentation 2 by Dr. Saumya Agarwal
Mortality Meet Presentation 2 by Dr. Saumya Agarwal Central Institute of Orthopaedics, Safdarjang Hospital and VMMC, New Delhi
A 48-year-old male farmer presented with pain and swelling in his right thigh for 10 days following a fall. Examination found restricted and painful right hip and knee movement. Investigations revealed anemia and elevated ESR. He was admitted for right femur fracture and developed respiratory distress. His condition deteriorated and he suffered cardiopulmonary arrest. Resuscitation attempts failed and he was declared dead from a suspected pulmonary thromboembolism complicating his injuries, diabetes and hypertension.Clinicopathological conference
This document presents the case of an 11-year-old thalassemic girl who presented with drowsiness, irritability, and vomiting. Imaging revealed a large extradural hematoma that required surgical evacuation. Over the subsequent days, she was closely monitored and managed in the ICU. Her symptoms improved and she was eventually discharged with recommendations for outpatient follow up.
Long Case Template : Abdominal Pain and Vomiting 50 Year Old Male
Long Case Template : Abdominal Pain and Vomiting 50 Year Old MaleMedvizz institute of medical education
The patient is a 50-year-old male presenting with severe abdominal pain radiating to his back. He has a fever of 101.3F and is vomiting. His history includes diabetes mellitus. On examination, his abdomen is distended and tender in the right upper quadrant. Initial management should include oxygen, IV fluids, analgesia and antiemetics to make the patient more comfortable. Bedside investigations including an ECG, ABG and urinalysis should be obtained. Laboratory tests including a CBC, coagulation screen, HbA1c, liver function tests and a renal profile are needed.Case presentation on Iatrogenic Perforation
Mr. Mosharaf Hossain, 26, presented to the hospital with abdominal pain, distension, and shortness of breath. He had undergone a colonoscopy earlier in the day. On examination, he displayed signs of peritonitis including abdominal rigidity and obliteration of liver dullness. Imaging revealed free air in the abdomen. He was diagnosed with an iatrogenic perforation from the earlier colonoscopy and underwent an emergency laparotomy. Three tears were found and repaired in the sigmoid colon. The patient recovered well post-operatively and was discharged on the 12th post-operative day.
Postpartum Haemorrhage : Case Illustration
A 35-year-old woman experienced postpartum hemorrhage (PPH) after delivering a 3.9kg baby at a private facility. Despite treatments including ergometrine injections and oxytocin infusion, her uterus remained atonic and she experienced massive bleeding. She was transferred to a general hospital in a moribund state and died soon after arrival. A 30-year-old woman at a district hospital also experienced PPH after a vaginal delivery. Despite treatments including ergometrine, oxytocin, and uterine massage, she continued to bleed heavily and became lethargic with low blood pressure. She was transferred to a general hospital where a cervical laceration was suture
DEATH AUDIT.pptx
Mr. Santosh Misal, a 40-year-old male farmer, was brought to the emergency department after collapsing in the field with symptoms of a possible snake bite including sweating, frothing at the mouth, and involuntary urination. Imaging showed an infarction in the right middle cerebral artery territory consistent with a stroke. He developed coagulopathy resistant to 10 vials of antivenom. Despite supportive care including ventilator support and coagulation factor replacement, his condition deteriorated and he suffered cardiac arrest on the third day, passing away. The case highlights the neurotoxic and coagulopathic effects of snake venom that can lead to stroke and the challenges in managing severe envenomation.
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This document presents a case study of a 63-year-old male patient admitted to the emergency department after losing consciousness following an unwitnessed fall. Imaging revealed intraparenchymal hemorrhage, subdural hematoma, and a suspected occipital fracture. He was treated conservatively but his mental status deteriorated, requiring intubation. He later underwent craniectomy and placement of an external ventricular drain. Over the following days, he did not regain consciousness but remained hemodynamically stable. He was then given a tracheostomy and PEG tube. The document reviews his hospital course and treatments.
PPT-BLOOD-TRANSFUSION.pdf
This document defines blood transfusion and discusses its purposes, indications, contraindications, nursing assessment, preparation, procedure, documentation, complications, and sample documentation for blood transfusion. A blood transfusion involves infusing whole blood or blood components into the venous system to increase blood volume or specific blood components for various purposes such as increasing red blood cells, platelets, or clotting factors. The document outlines the nursing responsibilities and monitoring required for safe administration of blood transfusion.
Dealing with tachycardias
It is very common to see patients with different Tachycardias in Emergency department. Dealing with tachycardias as a part of ACLS is a must to know for all Emergency Physicians. This presentation covers different types of Tachycardias like Sinus Tachycardia, stable tachycardia, unstable tachycardia, ventricular tachycardia, supraventricular tachycardia, svt with abberancy, AIVR, TCA Toxicity, Ventricular paced rhythm, modified vagal maneuvre, atrial fibrillation and others
Total spinal
This document summarizes a patient's medical history and details of a surgical procedure under anesthesia. A 45-year old male patient presented with vomiting, weight loss, abdominal pain and fatigue. He had a history of perforation and laparotomy surgery. The patient was diagnosed with CKD and diabetes. He underwent a total spinal anesthesia for a 2-hour surgery to investigate enlarged mesenteric lymph nodes. During the procedure, the patient experienced hypotension and bradycardia due to the spinal anesthesia. He was intubated and given intravenous fluids and medications to stabilize him. After the surgery, the patient was extubated and able to follow commands with normal vital signs.
Mortality Meet Presentation by Dr. Saumya Agarwal
Mortality Meet Presentation by Dr. Saumya Agarwal Central Institute of Orthopaedics, Safdarjang Hospital and VMMC, New Delhi
This document summarizes a patient mortality meeting discussing a 45-year-old female patient who was admitted unconscious following a road traffic accident. She sustained injuries including a laceration on her right thigh and eye, as well as an intertrochanteric fracture of the right femur. The summary outlines her hospital course, management including surgery, complications including infections, and eventual discharge on day 26 after addressing cerebral salt wasting.Anaesthetic management of a patient with perioperative asthma
1. A 74-year-old female with a history of asthma and hypertension presented for an emergency CBD re-exploration surgery.
2. During induction, the patient aspirated, which precipitated a severe bronchospasm that led to irreversible hypoxia, hypotension, and cardiac arrest.
3. Despite maximal treatment and resuscitation efforts, the patient could not be revived and was declared dead. The case highlights the challenges of managing perioperative bronchospasm and aspiration in a high-risk asthmatic patient.
Swollen legs
This document discusses various potential causes of swollen legs, including:
- Venous obstruction from pelvic masses.
- Lymphedema.
- Infections.
- Certain medications like calcium channel blockers.
- Physiological swelling during pregnancy.
It provides examples of patients presenting with leg swelling and the doctor's evaluation, diagnosis and treatment recommendations for each case, which vary from infections requiring antibiotics to lifestyle advice for pregnancy related swelling.
Similar to Case no2 (20)
Anaesthetic Management of a Patient with HELLP Syndrome
Anaesthetic Management of a Patient with HELLP Syndrome
Presentation: PEDIATRIC KIDNEY TRANSPLANTATION: POST-OPERATIVE NURSING CARE
Presentation: PEDIATRIC KIDNEY TRANSPLANTATION: POST-OPERATIVE NURSING CARE
Mortality Meet Presentation 3 by Dr. Saumya Agarwal
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Mortality Meet Presentation 2 by Dr. Saumya Agarwal
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Long Case Template : Abdominal Pain and Vomiting 50 Year Old Male
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1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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