Member

…

via Movin’ Meat: AMS.

I haven’t looked at the numbers lately, but Altered Mental Status, or AMS, must be in the top ten, if not the top five most common ER presentations. AMS, as a triage complaint, is like a bizarre little birthday present for an ER doc. You just don’t know what you’re going to get when you walk into the room — and there’s a tremendous range of possibilities. It could be someone with a stroke, or a septic septuagenarian. Odds are, it’s just a drunk, or someone stoned on street drugs, or overdosed on prescription meds. Less exciting and much more work (and infinitely more likely to be a huge pain in the butt). They may have nothing at all, or something really trivial like a fainting spell. Sometimes you get the really interesting stuff presenting with AMS: a first time DKA or a carbon monoxide poisoning, for example, which is a fun detective game requiring good clinical skills. I’ve seen it all, a million times over, so I’m quite comfortable with the protocol, but you never really know what it is till you get in there.

[read the rest of the post here]

…

“Giddiness” is to Radiology as “AMS” is to the ER or Casualty as we call it in these parts.

Most Indian radiologists, if they stopped to think about it, probably would not be surprised at how many (walking-talking) people who come in for a CT Brain have “giddiness” as their only presenting symptom. It sure is a giddy world out there!

Incidentally, I saw a similar brain metastasis - as the one seen by Shadowfax - a few days ago. Different presenting story though. Not the pervasive “giddiness.”

An elderly gentleman had a sudden convulsion and was brought to the casualty. CT Brain showed a similar left parietal nodule with vasogenic oedema.

Image from Shadowfax’s post. I like his labelling!!

The patient that I saw had no prior history of cancer or any other major illness. Chest radiograph taken on admission showed a mass in the left hilum. CT Thorax done the next day confirmed a left parahilar malignancy with few metastases in the right lung, liver and ribs.

As in the American AMS, you never know what you’re going to get in an Indian giddiness, either.

And I agree with Shadowfax. Cancer Sucks.

Start Slide Show with PicLens Lite