There may be a time when you don’t *gasp* have an x-ray machine. Osteophony is a 19th century technique by which practitioners would use the acoustic properties of intact versus disrupted bone to determine if there was a fracture or dislocation. Extra points if you can get orthopedics to come see the patient based solely on osteophony!
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A middle-aged male presented in cardiac arrest. He had reportedly complained of preceding chest pain. Upon EMS arrival, his presenting rhythm was ventricular fibrillation (VF), which was refractory to multiple attempts at defibrillation. After receiving treatment for refractory VF, the patient had return of spontaneous circulation (ROSC). He was hypotensive, and ultimately required triple pressor support to maintain adequate mean arterial pressure. An initial electrocardiogram (EKG) was performed, which showed sinus tachycardia. A repeat EKG was performed one hour later, showing…
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A 36 year-old female presented with the acute onset of abdominal pain and sweating. She had taken multiple home pregnancy tests, all of which were positive, and then experienced a bout of severe dizziness. On physical exam, she was very pale, and had a flat, but tender abdomen. Soon after arrival, the patient became unresponsive, but was still breathing with rapid pulses. She was placed in reverse trendelenburg, and multiple attempts were made to get an automated blood pressure reading with no luck. Finally, a manual blood pressure of 70/58 was obtained. Fluid resuscitation was initiated and bedside ultrasound was performed…
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