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What did it turn out to be?

Not wrong at all with regard to the Tylenol, it can definitely mask a fever, I just believe there are other historical items that point away from infection. I could be just as wrong as anyone though.

Absolutely. If that is an abscess it is quite large. There should have been some sign of infection that was reported in the history, plus headaches for months make me think more tumor/chronic bleed.

Awesome sites, just a heads up however, uptodate is not free. Your hospital likely has a subscription which is several hundred dollars for an individual one. emedicine.medscape.com is a great site, similar information that is available on uptodate, and is free to signup.

Believe he was talking about this in relation to shock states and when to use pressors in general and not specifically for cardiac arrest.

usalsfyre is the winner, also known as the John Thomas sign. Though unfortunately I think there are some articles demonstrating it is an ineffective means of detecting pathology, having trouble finding them at the moment however.

I can assure you there are, work with them frequently.

From Goldfrank's Toxicologic Emergencies: "Cyanide is an inhibitor of multiple enzymes, including succinic acid dehydrogenase, superoxide dismutase, carbonic anhydrase, and cytochrome oxidase.130 Cytochrome oxidase is an iron-containing metalloenzyme essential for oxidative phosphorylation and...

No one is suggesting a pulse ox of 100% means everything is fine, but more FiO2 isn't going help that Hbg of 3... I use lowest FiO2 to keep patient above 94%.

For text books maybe, but no one carries one around in their coat pocket like they do Harriet Lane.

Post #11 has a link to an article. You can use that to track other citations you may find relevant.

Probably not. But there was also no malpractice on the part of the attending, he did everything he could to try and get this person to let him intervene earlier (essentially from the moment they came in), likely when the fetus still had a good chance. She was never incapacitated, refused all...

For anyone that thinks the OBs are wrong in their overly defensive decisions I'll tell a little story I witnessed on my time on L&D. Women comes in, has been laboring at home for several hours, came in because a CNMW insisted it had been too long. She comes in, refuses all care, initially...

For anyone interested, 2006 article from Obstetrics and Gynecology relating the risk of rupture in TOLAC. http://www.ncbi.nlm.nih.gov/pubmed/16816050 Edit: Should also point out we do nearly 100% Low-transverse sections here, which better allow for TOLAC later, in fact in 8 weeks the only...

Sorry, edited the post on you whilst you were typing your response. :ph34r:

Just finished 8 weeks of OB and we TOLAC (Trail of Labor After C-section, VBAC isn't used much anymore) nearly everyone...the risk of rupture is around 1%. There had to be a very compelling reason to section a patient if the only "indication" was previous section.

Then don't bother (not saying I disagree with how you handle traumas btw). U/S is difficult with a completely still patient. Trying to get a clean picture bouncing down the road is a complete waste of time.

I would have a high index of suspicion for a dissection. This could also just be a hypertensive emergency.

Picture is small, and when I increase it I lose detail, so it's tough to make out. I convinced myself a few of the frames show ring enhancement. Best guess looking at those pictures is either an abscess (though unlikely with no fever or other indications of infective process) or tumor (with the...

I missed this earlier. Actually in the US if you have an unrestricted license (MD + one year post grad training) you can do whatever you want. Now facility credentialing is a separate issue.