Archive for the Neurological Category

I just passed out!

Posted in Neurological, Pathology, Prehospital Care with tags , on May 10, 2010 by The Beaver Medic

As you begin lathering your hair and launch into the second verse of Calendar Girl the tones of your pager sound. Still shampoo’ed but now uniformed you dart out the door. Dispatch has a First Responder call for a 28-year old unconscious female. En route to the station you daydream about using an airway and bag valve mask on somebody other than a CPR dummy.

Your Engine’s code three arrival has drawn more people to the neighbouring lawns than you thought lived in this town. With jump kit and supplemental oxygen in hand you stumble onto the lawn. Just as your helmet slides over your eyes, yet again, you notice Mum standing calmly in the door. Wait, something is wrong here. Where is the arm waving? Where are the airport ramp “they’re in here” signals? Mum seems more concerned about her prized geraniums you just trampled on. Those and the size 12 top-soil prints you are trekking on her new carpet. Strange…

Once you enter the the living room it all becomes clear. Seated inside are a nervous boyfriend, Dad cursing the Jets for a missed field goal and a very embarrassed, though conscious, 28 year old female.

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Pathology of the Week – High-altitude illness

Posted in Neurological, Pathology of the Week, Respiratory, Technical Rescue with tags , , , on May 7, 2010 by The Beaver Medic

During the past few years I had the opportunity to learn mountaineering and ice/rock climbing from a few storied guides. I even got to climb one of Canada’s sixteen 10,000′-plus peaks. Although neither of us developed any form of high-altitude illness the trip prompted me to research the disease. High-altitude illness encompasses a group of acute pathologies which affect the bodies of individuals not accustomed to altitudes over 2,500m (8,202 feet) above sea level. These are acute mountain sickness (AMS), high-altitude cerebral oedema (HACE) and high-altitude pulmonary oedema (HAPE). AMS is far more common than HAPE and HACE with the latter two occurring in less than 0.1 to 4.0% of ascent cases. AMS equally affects both men & women as well as paediatric & adult patients. Strangely individuals over 50 seem to have a lower risk of developing AMS.  I will reference Basnyat & Murdoch, 2003 (free public access) as well as the Merck page on Altitude Sickness. See also BaseCamp MD.

Signs and Symptoms

Climbing Mt. Baldwin, summit: 10,682 ft

We in Canada actually contributed to the diagnosis of AMS!  The Lake Louise Consensus Group defines AMS as a new onset headache, in an unacclimatized person, who has recently travelled above 2500m as well as at least one of the following: fatigue, nausea, vomiting, loss of appetite, dizziness, and/or sleep disturbances. The symptoms typically begin 6 to 10 h after ascent and spontaneously subside after one to two days. Continue reading

Pathology of the Week – Horner’s Syndrome

Posted in Neurological, Pathology of the Week with tags , on April 14, 2010 by The Beaver Medic

Horner’s Syndrome: Medicalese: named after Swiss ophthalmologist Johann Friedrich Horner in 1869.

This disorder is an interesting one to study as it involves some of the more complex cranial and autonomic nervous pathways. Horner’s syndrome is a grouping of four autonomic symptoms that arise from a loss of autonomic sympathetic nervous system input. These four symptoms are ocular ptosis, ocular miosis, facial anhydrosis and facial hyperaemia. All just big scary medicalese terms which I will detail below. I will reference the Merck Manual’s quick review, Jeff Mann MD’s guide, as well as an excellent neuroimaging article Lee et al, 2007 (article is free access).

Courtesy of OD Palace

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