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FW: Old lady in MVC

Robert Smith rfsmithmd at comcast.net
Tue Feb 13 16:20:41 GMT 2007


In David Livingston's most excellent paper I believe the patients that had
"only free fluid" were absolutely pristine except for that finding. No
hypotension plus free fluid. Though it's hard to improve on "stable", she
had already had a few episodes of hypotension without a known cause. Old
folks lack the physiologic reserve that we're used to dealing with and who
knows if she would bounce back from the next episode if there was one.

Confusion post trauma. Hmmm. She's now a few days out right? One would think
a structural lesion would have manifested itself sooner, so it might not be
because of trauma. On the other hand if she showed up in the ED with
confusion as her chief complaint everyone would get a CT.

Rob Smith





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