List Archives

Tue Feb 13 20:36:00 GMT 2007

Wouldn't emboli give a specific vascular distribution?  She didn't have
that. 

Errington C. Thompson, MD, FACS, FCCM
Trauma/Surgical Critical Care
Mission Hospital
Asheville, NC
Author - A Letter to America
www.whereistheoutrage.net

Everyone deserves to make an informed decision
                                - Errington Thompson, MD

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Krin135 at aol.com
Sent: Tuesday, February 13, 2007 3:13 PM
To: ccm-l at ccm-l.org; trauma-list at trauma.org
Subject: Re: ccml RE: Old lady in MVC

In a message dated 2/13/2007 1:38:56 PM Central Standard Time,  
ecthompson at msn.com writes:

The  daughter mentions that the patient slept soundly all night.   
Unfortunately, the patient was unarousalable following morning.  A stat  CT
of the head 
revealed several areas of infarct.  These areas were not  confined to a 
specific distribution.  Comfort measures were  ordered.

where is she showering microemboli from? Any otherwise occult history of  
Afib that might have had a little clot in the left atrium that broke up? or
an  
ulcerating lesion in one of the carotids? I'm not seeing anything to make
me 
think that she'd have something that would make it through the lungs from
the  
systemic circulation at this point.

While it may be a moot point right now, I'd be looking for an
echocardiogram 
and a duplex carotid Doppler as noninvasive, non dye load  tests.

ck
Charles S. Krin, DO FAAFP
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ccml RE: Old lady in MVC