Medical. : Medicine.


Verified Military
Jul 30, 2008
Wrong side of heaven, righteous side of hell
I know there is a subject on Combat Medicine but it is broad subject matter. This is a place where we can discuss and learn things regarding the Military way v/s. the civilian way. I am open to comments and help on how to make this a educational group.

We could always do some case studies/things we have seen and lessons learned. Improving skills/knowledge can never be a bad thing.
HEY!!!!! I guess no one wanted the resident Flight/stepchild medic to play? geez... I feel like the nerdy white kid who got picked last on the playground.... :(

assholes!! :D

bring on the scenarios!!
Don't cry bro. I love you bro.

35 y/o female, Cao x 4, obvious distress with the C/C: S.O.B./hoarse voice and dysphagia with a h/x of a tooth infection, bottom Lt. row. Pt. is tachycardic, normotensive, febrile with obvious edema and hardness of sub-mandiblar tissues noted over mandible and unable to open mouth fully.

Diff d/x. and treatment (E.M.S.) and 18D level please.

Had this call the other night.

it's an abscess, and it's definitely infected. On assessment of the oropharynx what do you see? also, approx which tooth was the infected one? I suggest an I&D of the Abscess followed by Augmentin 500mg PO TID for 10 days.
Ludwig angina (name derived from sensations of choking and suffocation) is characterized by brawny boardlike swelling from a rapidly spreading cellulitis of the sublingual, submental, and submandibular spaces with elevation and edema of the tongue, drooling, and airway obstruction.3 The condition is odontogenic in 90% of cases and arises from the second and third mandibular molars in 75% of cases.3 If infection spreads through the buccopharyngeal gap (space created by styloglossus muscle between the middle and superior constrictor muscle of the pharynx), potential exists for adjacent retropharyngeal and mediastinal infection
OK Guys: try this one on.

Run call: 58 yo fem cc: left sided sub costal pain radiating up towards axilla. VS: 156/88 P 96 R 24 Let's do it from the beginning. What info do you want before you make a differential dix?
uh, shit. without cheating and using google...

mech of injury? Onset? Provocation? Quality? Severity? Time/duration? Interventions? "Ma'am, do you have any previous history of heart problems or chest pain I should know about? what about surgeries? any recent or past surgeries? are you taking any medications, any over-the-counter meds, supplements, vitamins, anything? do you drink or smoke?"

I'd start with those. :D whatcha got?
Yes Helo, w/o using google (you dont have google in the field do ya??)

Sudden onset while doing routine housework. Onset within past hour. No hx of cardiac/ HPB. Only surgeries childbirth over 20 yrs ago. Light social drinker, lifelong non smoker. Takes a daily multi vit and has been on low dose HRT for the past 6 mos. for perimenopausal symptom control.
I wasn't asking if I could use google ... I was telling you I wasn't going to, silly! and no I don't have it in the field, but in fairness, I don't have 58 y/o females in the field, either!! :D

Provocation? Quality? Severity? does respiratory exchange cause pain? or is the pain separate from that? any other symptoms: NVD, dizziness, etc?

I'm not gonna lie, this is quite a bit out of my norm and comfort zone, but I'm glad for the practice.
yes the pain increases on deep inspiration no NVD no dizzy

This isn't a problem of just females, its right out of the Special Forces Med Handbook, I just made your patient female for fun.
k - how about inspection/palpation/auscultation/percussion of the chest and axilla? is the L chest wall TTP? any erythema/ecchymosis? deformities?