By nanadadzie | November 26, 2008 - 3:01 pm - Posted in Cases
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A 24-year-old woman is shows up in the ED, 27-weeks pregnant, febrile and with mental status changes. And, BTW, she has a history of intravenous drug abuse. And she has missed most of her prenatal visits.
During her work, whe is noted to have a significant diastolic murmur. Echo shows endocarditis of the aortic valve with wide open aortic regurgitation. The fetus looked fine. Due to risk of decompensation with probably fatal consequences for mother and fetus, the decision was made to take the patient to the OR for first a Cesarean and then aortic valve repair (AVR).
Fast forward 6 hours – the baby is in the NICU. Apgars were 8 and 9. The mother is in the ICU, after a AVR witha #21 bioprosthetic valve on low dose Norepinephrine and Propofol! Her hemodynamics are stable as a rock and there is no sign of bleeding.
Not only cats have 9 lives!
By nanadadzie | November 6, 2008 - 9:32 pm - Posted in Cases
This 66-year-old man came in last night while I was on-call.
Well, he was harvesting corn that afternoon with his corn picker when the machine stalled.
An ear or two of corn was stuck. Most normal folk will get a stick and push the ears of corn further.
Well, not him!

He sticks his right hand in the still-running machine and bingo!, the corn picker grabs his hand starts mincing it.
The ne’er-do-well machine stalls again with his mangled hand in it so what does he do?
He takes out his pocket knife and amputates his forearm about 6 inches above the wrist!
We obtained this video from the bronchoscopy of a 7-year-old boy who aspirated a piece of meat.
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