Unexpected Turns

She watched the Camry coming straight at her, obeying the laws that Newton laid out: a body in motion stays in motion until an external force intercedes.   Her husband, daughter, and the TV weatherman had told her not to go out. Ice had descended on the city earlier in the day, making even the walk to the garage precarious. But she needed milk to make a cake for the next day’s party, and the store was only three blocks away. Her plan was simple: store, milk, home. That might have worked if not for the Camry that became a hockey puck on the ice.   The next couple of hours were a blur but proceeded as readers would expect: 911, paramedics, backboard, cervical collar, ambulance, IV, medicine, stabilization bay, ultrasound, x-rays, more medicine, scanner, hospital bed. All she remembered from that first day through her fentanyl fog was someone saying, “Only a fractured hip. With surgery, this should all be a bad memory in a year.”   She had suffered an acetabular fracture and femoral head fracture. (Figures 1 and 2.)   Figure 1. Pelvic AP x-ray.   Figure 2. Still image from CT scan showing details of acetabular fracture and femoral head fracture.   The next morning she developed atrial fibrillation with a rapid ventricular rate. (Figure 3.) Surgery was postponed, and cardiology was consulted. She was asymptomatic and maintained normal blood pressure despite the rhythm change. The ECG showed diffuse ST-segment depression concerning for subendocardial ischemia, which c...
Source: Spontaneous Circulation - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs