Man in his 70s seeks the ED for low abdo pain. Has a lymfoma in the abdomen, last CT 3 days ago showed no bowel obstruction. On prednisone to reduce swelling. No vomiting. #POCUS shows dilated small bowels with free fluid. CT confirms SBO secondary to obstructive tumour. #EMIMCC

A woman in her 70s seeks the ED for CP starting 10 days ago, worsening today. ECG with new LBBB. Normal echo just 18 months ago. Troponin 20. #POCUS shows a dilated left ventricle, EF 20%. Also bilateral pleural effusions. Clean cath. Sometimes things just happen quickly I guess 🤷‍♂️ #EMIMCC

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A female in her 20s seeks the ED because of right lower abdo pain staring 10 days ago. 4 weeks since her last period. No birth control. Hemoglobin of 115. #POCUS shows a corpus luteal cyst and some free fluid. Diagnosis: Hemorrhagic corpus luteum with rupture. Patient did fine. #EMIMCC

A man in his 40s seeks the ED because of 3 days of left sided flank pain and nocturia. 3 weeks ago he had an operation for a benign tumor which was compressing the left ureter. Has a ureteral stent. #POCUS shows hydronephrosis. CT unfortunately with a perforated stent, see below 👇 #EMIMCC

Another day, another massive SBO. Elderly woman with mets in the abdomen. Pain masked by chronic steroid use. Liters of vomit in the nasogastric tube. Poor soul. #POCUS #EMIMCC

Gotta love the accidental finding of a non-ruptured aortic aneurysm in a patient with Myelodysplastic Syndrome #POCUS #EMIMCC

Another day, another uncomplicated repeat episode of diverticulits. CRP in the 60s. CT confirmation not necessary. #EMIMCC #POCUS

1) A man in his 70s seeks the ED for CP starting 45 min ago after a brisk walk. Ambulance ECG 25 min earlier shows lateral changes that are unfortunately missed (shown below). Ongoing CP. #EMIMCC

Woman in her 80s seeks the ED for a swollen calf since 3 weeks and now exertional dyspnea. Not a hard diagnosis. #POCUS shows a large right ventricle and D-sign in the basal septum (which is why it’s only in one of the recorded beats here). Also, of course, a DVT. #EMIMCC

50y old man, level 1 trauma. Fell 3 m off a ladder, BP 85/55. CAB is stable. FAST exam shows free fluid, crit care doc screams ”blood in the belly!”. Fluid looks odd, CT non-confirmatory. During op management, feces everywhere. Turns out it was an anal insertion causing perforation. 🤷‍♂️ #EMIMCC #POCUS

A 40y woman came to a sudden stop on her bicycle and felt a sudden pain in her calf. Thompson test negative. #POCUS shows irregularities consistent with a partially torn achilles tendon. Ortho at my place wants to treat it like a full tear. Seems excessive. How is management at your place? #EMIMCC

A woman in her 60s seeks the ED for CP starting 2 h ago. ECG concerning for ST elevation in anterior leads. #POCUS shows hypokinesis septally. Gets transferred for urgent cath which shows a 100% LAD stenosis. Succesfully stented. Repeat echo normal. #EMIMCC

Ingen vet vad ett beredskapssjukhus är men alla nedläggningshotade småsjukhus vet att just de är unikt lämpade att bli ett. lakartidningen.se/nyheter/har-...

Här vill man räcka upp handen för beredskaps­sjukhus

»Vi känner att Lycksele är ypperligt lämplig kandidat«, säger Nicklas Sandström (M), förste vice ordförande i Västerbottens regionstyrelse.

lakartidningen.se

A woman in her 90s seeks the ED because of jauneice. It came from nowhere a week ago and she is feeling fine otherwise. #POCUS shows a severly dilated common bile duct. CT without malignancy but a 4 cm obstructive duodenal diverticulum. This is (apparently) Lemmels syndrome. #EMIMCC

A woman in her 60s seeks the ED for 10/10 CP that lasted an hour. Now 1/10. Vitals, ECG unremarkable. #POCUS shows a dissection flap in the abdominal aorta. No pericardial effusion. CT confirms dissection from aortic valve to the iliac artery. Surgery successful, full recovery. #EMIMCC

Att leva i allvarlig materiell och social fattigdom är att svara nej på minst sju av nedanstående punkter. Vardagen är rätt kämpig då. Att antalet personer som har det så här har tredubblats på bara några år är, eller borde vara, en megagrej

Olle Bergvall@ollebergvall.bsky.social · 5mo ago

Sedan 2021 har antalet svenskar som lever i allvarlig materiell och social fattigdom har nästan tredubblats, från 150 000 till 408 000. Vi frågade Tove Samzelius, lektor i socialt arbete, vad den drastiska ökningen beror på. "Jag skulle tyvärr säga att det inte blir bättre"

A man seeks the ED because of CP and dyspnea. Low sats, slightly tachycardic. He suddenly gets worse. #POCUS shows a clot in transit. Before Alteplase is given he goes into cardiac arrest. Luckily he only needs a couple of minutes of CPR after Alteplase is given. Full recovery. #EMIMCC

There is nothing magical about formal ultrasounds for appendicitis. We EM docs can do it too! 32 y old male with a classic history, CRP 94. #POCUS shows an appendicolith and an inflamed appendix. Surgeon moves up the operation because of risk of perforation. #EMIMCC

A woman in her 90s with known rectal ca seeks the ED for general malaise. She was put on Bactrim for a UTI 2 days ago. Creatinine 125, CRP 120. #POCUS shows hydronephrosis of the left kidney. CT confirms a large metastasis, compressing her urether. Nephrostomy needed. #EMIMCC

Woman in her 30s seeks the ED for pain in the epigastric region. Her abdo exam shows RUQ pain that combined with an elevated ALT increases suspicion of presence of gallstones. Bilirubin 17. #POCUS shows a dilated common bile duct and a stone. Admitted and operated on the following day. #EMIMCC

A man in his 50s seeks the ED for the 3rd time this month. His visits before was diagnosed as a viral infection. Now he has fainted, has CP, is SOB and has a sat of 88% on room air. Not a hard diagnosis, but #POCUS clinches it. (And yes; he had right heart strain as well) #EMIMCC

När DN begärde ut offentliga handlingar av Regeringskansliet kom de, utskrivna på papper, efter 30-46 dagar. När fiktive ”Simon” gjorde motsvarande levererades de, digitalt, efter två. www.dn.se/ledare/peter...

Peter Wolodarski: Så motarbetade regeringen DN:s granskning – tills Simon började ställa frågor

Ständiga förhalningar blev den journalistiska vardagen när Sveriges nationella säkerhetsrådgivare granskades. Tills en oväntad person ställde frågorna.

dn.se

"World's first potential trillionaire has killed 600,000 people, including 400,000 children" is the only headline that anyone should ever read about Elon Musk

The New Yorker@newyorker.com · 9mo ago

One analytical model shows that, as of November 5th, the dismantling of U.S.A.I.D. has already caused the deaths of 600,000 people, two-thirds of them children. https://newyorkermag.visitlink.me/jUzNSc

A prev healthy man in his 50s arrives by EMS with a GCS of 9. It started an hour ago with him screaming ”I can’t breathe” and then having a seizure. He flails with only his left arm on the stretcher. Looks sick so he gets an artline quickly - 95/55. #POCUS gets the diagnosis. Scary stuff. #EMIMCC

Who did this?!

Man in his 70s with CP starting 2 h ago. Similar, shorter duration yesterday. Now almost painfree. ECG read as normal by first physician 🤯. #POCUS with apikal hypo/akinesis. Sent to PCI 90 min away. CP again with ST-elevation so emergent cath. LAD stented. #EMIMCC

Jag saknar förritin, när folk hade skam nog att smussla med korruptionen åtminstone www.dn.se/sverige/avsl...

Avslöjar: Friskola arrangerar evenemang – i statsministerns hem

Friskolan i Strängnäs, Europaskolan, arrangerar en exklusiv middag. Gästerna välkomnas till Sagerska huset – statsministerns officiella…

dn.se

A man in his 80s visits the ED because of epigastrialgia. The resident sends him home with a diagnosis of gastritis (even though CRP was 30). Comes back 2 days later, CRP now 250. Diagnosis was not hard at that point. #POCUS #EMIMCC

A man in his 50s seeks the ED for the umpteenth time since his abdo pain started a few years ago. He says that it’s his gallbladder, surgery has been denied because of diffuse pain and normal blood tests. Today CRP 9, Leukocytes 11. #POCUS He got his operation the next day. #EMIMCC