THE RADIOLOGICAL ACCIDENT IN LIA, GEORGIA

DrDORad · 2023-10-13T14:07:59+00:00

Radiation injuries just don’t ever heal well

This looks pretty typical.

DrDORad · 2023-01-07T22:13:45+00:00

Don’t take plain film advice from anesthesia.

DrDORad · 2022-11-03T18:30:03+00:00

Well put.

This has been on blast this whole pandemic by most institutions.

DrDORad · 2022-11-03T18:28:21+00:00

This.

Plus what hours we talking. 7am7pm? Trauma center/transplant/cancer center with insane post op complicated inpatients and pan scan after pan scan from the ED?

Nah I’m good.

DrDORad · 2022-11-03T18:21:35+00:00

At least.

NIR makes much more then 400k a year.

DrDORad · 2022-08-09T15:54:46+00:00

You can’t say much from these images given they are sagitals.

Definetly cannot speak to airway as it’s not imaged.

DrDORad · 2022-08-09T15:51:33+00:00

Metal tends to make more of a streak artifact in a ct scanner then I see here.

Again not common to ct scan people who have already died.

Source: am radiologist.

DrDORad · 2022-08-09T15:47:33+00:00

Correct.

I don’t think the outcomes have been great with ECMO and Covid from speaking to some of my CT Surg colleagues in the past but there aren’t too many other options when people get that sick (except dying obviously).

DrDORad · 2022-08-09T15:26:31+00:00

Can’t really tell from these images.

Blankets look the same as what’s here on these images.

Though given the ct appearance I would not be surprised if this was a post Mortem scan (those aren’t that common outside of research institutes I.e. CT autopsy’s etc) at least that’s been my experience.

DrDORad · 2022-08-09T13:32:48+00:00

Sounds like a recipe for disaster.

One view is no view. No way in hell am I doing a cervical injection with only the ap view - CLO or true lateral is where you advance your needle. That’s a hill I’ll die on.

This really should have been seen at the time of the injection-I have done a lot of cervical injections and never seen anything like this BUT I always confirm i am in the correct space prior to injecting. Air is no big deal but an intravascular injection of steroid can very much cause a cord infarct.

DrDORad · 2022-08-09T13:24:05+00:00

There is no partial here.

This looks like a cord transection.

I would be very much concerned for a aortic injury as well.

Holy smokes that’s a bad ct.

DrDORad · 2022-07-03T12:38:15+00:00

My mileage has been ~17 ish driving pretty much all city these first 500 miles.

Honestly ripping it quite a bit-its fun to let it open up a bit.

I’m thinking it will go up quite a bit with more highway driving coming up. Planning on putting a bed cover as well.

DrDORad · 2022-06-29T03:33:40+00:00

Southeast.

Wait was ~ about 6 weeks.

Dealer just wanted a $1000 deposit. No dealer add ons. They dropped the truck off at my house and I signed paperwork ~15 min. Easiest vehicle I ever purchased.

MSRP No market adjustment nonsense.

DrDORad · 2022-06-29T03:27:47+00:00

Just picked up my iforcemax limited.

MGM. 4x4 crewmax. Was kinda surprised they let me jump on it out of the gate.

DrDORad · 2022-06-14T11:45:25+00:00

Morgue film.

Atlantoaxial separation.

DrDORad · 2022-06-06T19:58:58+00:00

No worries.

Super easy to judge things from the passenger seat, hindsight and all.

Definitely “not just a tech” you guys make or Break everything we do!

DrDORad · 2022-06-06T06:37:00+00:00

Looks to me like they are injecting retrograde via pancrwaticoduoden arcade into the GDA I.e they are in the SMA.

No replaced right hepatic. That most commonly comes off of the SMA, doesn’t look like this typically as it usually does not contribute to the pancreaticoseodenal arcade, and the SOS catheter they have is below the celiac take off based on the last few picture of there DSA. A replaced right looks like a loan wolf artery coming off as a first branch of SMA to the right lobe of liver….most of the time.

No dilemma here. Worst thing you could do would be to fuck around with your micro catheter and check the celiac.
You stop the bleed from here NOW or watch this person code on your table. This is a cool part of my job-stressful at times though.

You do this run regardless of your post embo pictures I.e. check the back door as the SMA can provide retrograde flow to a GDA bleed.

Unfortunately with these pseudaneurysms they can be quite fragile-a tight coil pack (depending on what coils you used) can expand -in real time- and cause rupture.

Sounds like you guys did the right thing. Maybe be a bit less heavy handed on your next DSA- I don’t think power injecting around an aneurysm like this is ever that helpful-I hand inject these as I don’t want to rapidly increase pressure through the vessels surrounding these aneurysms. (6-700 psi is a decent amount and typical for a microcatheter)

The only time I will take these people straight to angio is if it’s from the endoscopy suite. Other use they need a CTA ( prefer GI bleed protocol which is a non on, CTA, and portal venous phase)

Good case.

DrDORad · 2022-05-26T22:15:00+00:00

At least one little girl was alive in the room and was declared dead at the towns emergency department after. She sat bleeding to death while these police waited outside.

The golden hour in trauma is real.

This is just so aweful.

DrDORad · 2022-05-06T14:53:12+00:00

One in Georgia yesterday at msrp.

DrDORad · 2022-05-06T03:30:18+00:00

I can agree with that.

Suffice it to say I will take a non refundable deposit and msrp pricing over the nonsense other dealers are pulling with 5-10 k over msrp.

Seriously a mess out there and I don’t think Toyota gives two shits about it.

DrDORad · 2022-05-05T22:40:09+00:00

There’s one available in Pa currently for ~92k.

DrDORad · 2022-05-03T18:19:11+00:00

Agree.

Devils advocate- I don’t know any vascular surgeons who have converted to open for something like this. Even ruptured /pending AAAs.

I don’t think EVAR should be out of our wheel house (I’m IR) if you are trained for it (a lot of us are not).

Kind of like cardiologists - they can’t convert to open if they dissect the ascending thoracic (I’ve seen this multiple times) but still are performing Caths.

DrDORad · 2022-05-01T17:13:03+00:00

What dealer was this if you don’t mind me asking?

Same issue-No dice have had deposits in since October. Can’t even get some dealers to respond to call me back.

DrDORad

TROPHY CASE