letmesleep Posted August 19, 2008 Posted August 19, 2008 this is what I found so far. I have highlighted some areas of the articles, as well as, provided the link. http://www.emedicine.com/emerg/topic490.htm Massive PE causes hypotension due to acute cor pulmonale, but the physical examination findings early in submassive PE may be completely normal. Initially, abnormal physical findings are absent in most patients with PE. After 24-72 hours, loss of pulmonary surfactant often causes atelectasis and alveolar infiltrates that are indistinguishable from pneumonia on clinical examination and by x-ray. New wheezing may be appreciated. If pleural lung surfaces are affected, a pulmonary rub may be heard. The spontaneous onset of chest wall tenderness without a good history of trauma is always worrisome, because patients with PE may have chest wall tenderness as the only physical finding. In patients with recognized massive PE, the incidence of physical signs has been reported as follows: 96% have tachypnea (respiratory rate >16/min) 58% develop rales 53% have an accentuated second heart sound 44% have tachycardia (heart rate >100/min) 43% have fever (temperature >37.8°C) 36% have diaphoresis 34% have an S3 or S4 gallop 32% have clinical signs and symptoms suggesting thrombophlebitis 24% have lower extremity edema 23% have a cardiac murmur 19% have cyanosis here is what I was able to find so far on traumatic asphyxia: http://www.bradylabit.com/classes/forensic...71,18,Traumatic Asphyxia Everything that I have seen so far about traumatic asphyxia, has not touched on "nipple line" cyanosis, but with the reading I have had you can certainly see where this idea came from.
boeingb13 Posted August 20, 2008 Author Posted August 20, 2008 Im glad you all thought a good bit about this senario, i know I didnt give alot of info, but what I gave was pretty much what we saw on scene. The throat had us all wondering ourselves, there were so many ideas as to what it could be. But like one response stated, " I'll never forget this one". Im trying to get together some other good ones that had us really thinking. Thanks for all the responses.
firedoc5 Posted August 20, 2008 Posted August 20, 2008 Im glad you all thought a good bit about this senario, i know I didnt give alot of info, but what I gave was pretty much what we saw on scene. The throat had us all wondering ourselves, there were so many ideas as to what it could be. But like one response stated, " I'll never forget this one". Im trying to get together some other good ones that had us really thinking. Thanks for all the responses. You're welcome. Keep 'em coming, Bo.
zzyzx Posted August 20, 2008 Posted August 20, 2008 I'm coming late to this, but about the "blue from the nipple line up" thing....I have also heard this anecdotaly. Some time ago when I did a lot of internet research on PE's, I never saw this mentioned in any of the literature. Anyway, it doesn't really make any sense when you think about it.
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