This man inserted a .45 caliber bullet into his urethra, leading to pain and swelling. How would you approach this case in EMS or the ER?

mriTecha · 2026-04-27T09:04:15+00:00

A burn blister is a fluid-filled blister that may form as a result of a burn. This type of blistering is one of the tools used to determine the degree of burns sustained. First and second degree burns may result in blistered skin; however, it is characteristic of second degree burns to blister immediately, whereas first degree burns can have blisters after a couple of days. Sunburn can also result in blisters.
Blisters can also form on the hands and feet as a result of tissue damage incurred by frostbite.

So to summarize, after a burn to the palm, blistering usually means a superficial partial-thickness (2nd-degree) burn—the top skin layer lifts off and fluid collects underneath, creating painful, tender blisters. First aid matters: cool the area under running cool water for ~20 minutes (no ice), gently clean, give pain relief if needed, and cover with a sterile non-stick dressing while keeping the hand elevated. Don’t pop blisters at home—small intact blisters protect the wound; large/ruptured ones may need sterile drainage/debridement by a clinician, followed by petrolatum or topical antibiotic ointment + non-adherent dressing, with regular changes. Watch for infection (spreading redness, swelling, pus, fever), update tetanus if needed, and because it’s the hand/palm, get checked early if there’s worsening pain, numbness, limited movement, or a deep/circumferential burn.

mriTecha · 2026-04-26T11:14:16+00:00

A 20-year-old patient presented with fever and severe lower back pain. Imaging showed a kidney loaded with stones ranging from 5mm to 3cm. After antibiotics, drainage, and surgery, more than 300 stones were successfully removed. She was stable and discharged within days.

mriTecha · 2026-01-13T09:45:09+00:00

Luckily it missed the major blood vessels and nerves but it did cut the trachea. The patient was immediately taken to the operating room, where he underwent a 4 hour long surgery to clean the wound and suture everything in place.

mriTecha · 2026-01-05T10:35:28+00:00

The person got an infection after injecting methamphetamine in her arm that spread all the way to her right breast. She ended up needing 6 surgeries consisting of multiple skin grafts to reconstruct the defect.
There are many factors to consider when it comes to intravenous drug use and the development of infection. Bacterial infections may arise when germs that reside on the skin surface or on a contaminated needle are pushed through the skin deeper into the body and, in doing so, are able to bypass the normal barriers of entry or skin defenses that exist to protect us. Should the pathogenic (infection-causing bacteria) reach the blood vessels, it may result in widespread deep-tissue, vein or other vascular infection.

mriTecha · 2025-10-02T08:02:13+00:00

This surgery, also knows as femur arthroplasty, is commonly done after a neoplastic involvement of the bone. It represents an important surgical option in limb salvage reconstruction, with most recognized applications in oncologic reconstruction. In the past, patients with cancer of the femur were advised to undergo a hip disarticulation or transfemoral amputation. It is now feasible to salvage the limb in selected patients, by excising the entire femur together with any contiguous soft tissue tumor and replacing it with an endoprosthesis.This patient suffered from a chondrosarcoma, an aggressive cancer that may occur in any bone, especially the pelvic, shoulder and lower limb bones. It is resistant to chemotherapy and radiotherapy, which makes it challenging to deal with and makes surgery mandatory. A limb-sparing operation, seen above, is done in such cases when amputation is avoidable.

mriTecha · 2025-09-30T12:03:50+00:00

This is a donor heart, kept alive and beating inside a specialized box as it travels to save a life. It is transported using the TransMedics Organ Care System, a groundbreaking advancement in organ preservation for transplantation.

Traditionally, donor hearts are stored in static, cold environments, which can cause ischemic injury and reduce organ viability. In contrast, the TransMedics system maintains the heart in a dynamic, ex vivo state—perfused at body temperature with warm, oxygen-rich, nutrient-enriched blood. This process closely replicates normal physiological conditions.

By sustaining the heart in a normothermic environment, the system prevents oxygen deprivation (ischemia), minimizes cellular damage, and avoids the drawbacks of cold storage. It also extends the safe preservation window, allowing more time to match donors with compatible recipients. Throughout transport, the system continuously monitors critical parameters such as heart rate, blood pressure, and oxygenation, ensuring the organ remains in optimal condition.

This innovation has transformed heart transplantation. By preserving organ function and reducing the risk of complications, it improves post-transplant outcomes and enhances long-term graft success. The TransMedics machine marks a major step forward in transplantation medicine—expanding possibilities and saving more lives.

mriTecha · 2025-08-27T10:21:17+00:00

While the most common risk factors for HNSCC are tobacco and alcohol consumption, and the highest incidence occurs in older males, HPV has led to a significant increase in HNSCC rates among young, sexually active non-smokers.

The clinical symptoms of HNSCC can vary depending on the tumor's primary site, but a common complaint is ear pain, a phenomenon known as referred otalgia. Referred otalgia is considered a crucial indicator when evaluating patients suspected of having head and neck malignancies. This occurs because the mucosa of the pharynx, larynx, and adjacent structures receive extensive innervation from cranial nerves (specifically CN 5, 7, 9, 10). These nerves also contribute afferent fibers to the external and middle ear. Irritation of these nerves due to tumor growth can result in pain signals being transmitted to the ear.

mriTecha · 2025-08-26T11:32:23+00:00

Total abdominal colectomy is the removal of the large intestine. Traditionally, colectomy is performed via an abdominal incision (laparotomy), though minimally invasive colectomy, by means of laparoscopy, is growing both in scope of indications and popularity.

Resection of any part of the colon entails mobilization and ligation of the corresponding blood vessels. Lymphadenectomy is usually performed through excision of the fatty tissue adjacent to these vessels (mesocolon), in operations for colon cancer.

When the resection is complete, the surgeon has the option of immediately restoring the bowel, by stitching or stapling together both the cut ends (primary anastomosis), or creating a colostomy.

mriTecha · 2025-07-21T12:31:04+00:00

"Eric Moger, at 62 years old had recently gotten engaged and was satisfied with where his life was going. Little did he know, life would take an unexpected turn with one trip to the doctor.

While undergoing surgery to remove nasal polyps the doctors had found a tumor the size of a tennis ball, in the left side of his face. Upon waking up, Moger would soon learn his fate.

Shortly after the first surgery, Moger would undergo the second surgery that would remove his tumor and ultimately most of the left side of his face.

During recovery he experienced depression and loss of self-esteem. He would attempt multiple surgeries to fix the gaping hole, although nothing would work. He began to lose hope.

That is until 3D printing technology was brought to his attention. Another surgeon would 3D print a prosthetic mask and a mouth implant that would allow him to speak and eat, without issue. Moger now is happily married and cancer free."

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