Professional Documents
Culture Documents
Emergency Cases
Emergency Cases
25 yrs old male patient with no co morbids presented with H/O: Blunt trauma to chest due to RTA ------> 12 hour back
Two large I/V bore cannula, Crystalloids given.blood sample sent for cross match .
Disability:
GCS 15/15 .
Adjuncts:
A no allergy
M not significant. P not significant. L 3 hrs back.
Chest x-ray shows 3rd , 4th and 5th rib fracture on left
Pt. was kept N.P.O. 100 % oxygen inhalation. I/V line maintained. IV fluids, IV antibiotics, IV analgesics.
PostOp:
Kept NPO.
25 years old male patient with no known co-morbids came with c/o: Abdominal pain.8 days. Constipation. 2 days Abdominal distention2 days Fever.... .1 day
insignificant
A middle aged male of average built,dehydrated lying on bed,well oriented in time, place and person. Vitals:Pulse BP Temp. RR = 150 beats/min = 80/40 mm Hg = A/F = 22 b/min
Creatinine
Sugar
= = = = = = = = =
10.7 g/dl 17.2 539000 139 meq/lt 4.04 meq/lt 102 meq/lt 41 mg/dl 1.0 mg/dl 102 mg/dl
x.ray:
Shows distended bowel loops with multiple air fluid levels
Diagnostic tap:
appendix??.
Patient was kept N.P.O. I/V line maintained. IV fluids, IV antibiotics, IV analgesics and IV PPI.
done.
PostOp:
Kept NPO. I/V fluids,I/V antibiotics ,I/V analgesics and i/v proton
pump inhibitor.
Nebulization.
Input output charting.
Fever.. 7 days Abdominal pain ...4 days. Vomiting.3 days. Absolute constipation.....3 days
Not significant
Young male of average built lying on bed, dehydrated well oriented in time, place and person. Vitals:-
Pulse BP Temp. RR
Sugar
= = = = = = = = =
11.2 g/dl 13900 292000 123 meq/lt 5.00 meq/lt 86.5 meq/lt 54 mg/dl 0.9 mg/dl 94 mg/dl
x.ray:
Dilated large and small bowel loop.
Ultrasound abdomen: Distended bowel loops with fluid containing echos in the
upper abdomen noticed Gases in lower abdomen noticed Hypoechoic 4.7 cm *7.8 cm area containing echoes of fine septa consistent with collection in right side of pelvis Minimal ascitis noticed
typhoid??)
Patient was kept N.P.O. I/V line maintained. IV fluids, IV antibiotics, IV analgesics.
Drain placement under local anesthesia as patient was vitally unstable two drains were placed under LA Findings were 200 ml fecal staining fluid aspirated from right drain 200 ml of fecal staining fluid aspirated from left drain Per-op findings: on 3rd post admission day exploratory laparotomy done findings were: 1*1 cm perforation 4 cm proximal to IC junction Repair done and loop ileostomy made.
Anesthesia Progress:
Smooth recovery from anesthesia.
PostOp:
Kept NPO. I/V fluids, I/V antibiotics I/V analgesics I/V PPI Nebulization. Chest physiotherapy Input output monitoring
Subjective
Objective
: No active complaints.
ileostomy working.
: vitally stable.
Abdomen: gut sound audible Labs: Normal limits.
Lines Plan
: NG out.
: .
swelling on abdomen5 years constipation....7 days Abdominal pain ....2 days. Abdominal distention.2 days
ago
Old aged female of average built lying on bed, dehydrated well oriented in time, place and person. Vitals:-
Pulse BP Temp. RR
Sugar
= = = = = = = = =
12.8 g/dl 6300 242000 138 meq/lt 4.1 meq/lt 100.5 meq/lt 50 mg/dl 0.9 mg/dl 114 mg/dl
x.ray:
Dilated large and small bowel loop. Ultasound abdomen: Defect seen in ant abdominal wall measuring 3 cm.
paraumblical hernia.
Patient was kept N.P.O. I/V line maintained. IV fluids, IV antibiotics, IV analgesics.
Per-op findings:
done.
1.5 feet discoloured ileum 1 feet from IC junction ,right limited
Anesthesia Progress:
Smooth recovery from anesthesia.
PostOp:
Kept NPO. I/V fluids, I/V antibiotics I/V analgesics I/V PPI Nebulization. Chest physiotherapy Input output monitoring
Subjective
Objective
: No active complaints.
Flatus passed.
: vitally stable.
Abdomen: gut sound audible Labs: Normal limits.
Lines Plan
: NG out.
: Discharge.