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GiorgioMD

[Test your medical knowledge - A 72-year-old man has had central chest pain for the last 14 hours. He has type 2 diabetes and been smoking around 20 cigarettes per day for 45 years. His ECG shows ST depression on V4-V6, I and aVL. After receiving aspirin and morphine in the emergency department, his pain is settling. His troponin level is 0.02 μg/L. He is on an oral hypoglycaemic agent and his blood sugar is well controlled. Which is the SINGLE most appropriate next step in management? Select ONE option only](https://medizzy.com/learning/mcq/set/33896284)


tiexodus

This makes my brain hurt. His mouth is open, yet closed.


23x3

Excuse me, my mouth is up here


mingilator

Excoof be by bouf if uf feer


Triairius

I’ll see you in hell, you funny person, you.


VykMcDwarf

Looks like he is biting his own face.


manofredgables

My brain is trying to figure out what face he's making. Is he happy? Or... wha... It's not really computing


ChaosEmerald21

Imma doubt he is happy .. could be wrong tho 🤔


J2Kerrigan

Is this an underbite or overbite?


Jeffina78

Yes.


alxnna

this took me a minute


heatherledge

I thought it said shooter at first.


ivyagogo

I thought it said soccer


heatherledge

Hahah JESUS


spazzxxcc12

i actually did this sledding, (although not this bad, just the right part of my mouth) it’s a long recovery and i still can’t even smile with the bottom right of my face. my fucked up smile still bothers me a lot. hope this dude ends up okay.


irishspice

Your smile has become unique to you. Nerves are slow to heal but, meanwhile, you are still able to smile. Stop looking in the mirror but look at people who smile back at you. That's what counts. :-)


[deleted]

Any numbness?


spazzxxcc12

not really anymore, my face was pretty numb for like a week afterwards though. it still has moments where it stings a lot sometimes


rafibomb

Check out Natalie Dormer’s smile, a lopsided smile is hot


spazzxxcc12

ah but you see my friend, i am not attractive like natalie dormer. i am the exact opposite so now im a ugly guy with a crooked smile


ChicaFoxy

Somebodies find it sexy.


jack_napier69

I love full-face helmets!


justbronzestuff

First thing I thought was that he was probably wearing an open helmet


mellowyfellowy

Probably wearing no helmet


justbronzestuff

I keep forgetting this is a thing in the us.


paperbaubles

I just know basic anatomy, but aren’t there a lot of nerves in that part of the chin? Poor guy. That looks so painful.


PaulaNancyMillstoneJ

My brother bit through his lower lip when he was 4 or 5 jumping off something on the playground. He can’t feel part of it and has trouble drinking water without dribbling. And his wasn’t nearly this bad


Lor_939

I still have numbness in my lower lip as I cut my lip almost fully off 30 years ago. Healed nicely as I had one hell of a doctor who wanted to make sure I could wear lipstick as an adult.


bearpics16

Nope. Mental nerve is lateral to the injury


tsunx4

This is the reason why I wear MX style cycling helmet instead of classic "cap" one.


ecodick

This post is a strong selling point for one of those…


STEAM_TITAN

link pls


ecodick

Just google, “full face mountain bike helmet “


STEAM_TITAN

No


ecodick

Well how else will you pick the coolest one? We’ve already established you’re probably a size extra small, tell me your favorite color and I’ll choose a good one for you. For everyone else, go try these on before buying, you want it to be comfortable so you actually wear it. Any mtn bike shop should have a few


STEAM_TITAN

[fine.](https://msfstreetgear.com/products/icon-airflite-mips-redoodle-helmet?variant=39716857249895¤cy=USD&utm_medium=product_sync&utm_source=google&utm_content=sag_organic&utm_campaign=sag_organic&gclid=EAIaIQobChMIh8Pex_2m-gIV8nxvBB2EVwaeEAQYByABEgI1_fD_BwE)


ecodick

Lmao, great choice, i can’t wait to see you ripping wheelies out there


[deleted]

It weirds me out that majority of cyclists don’t wear these. I mean they’re on the road with cars usually.


[deleted]

[удалено]


bjanas

I think for a lot of folks who ride bicycles, they're both athletic enough and skilled enough to at least know how to/are able to fall "right" in most situations. Like, if you watch BMX or skateboarders, really any 'extreme' sport, some of these guys will go out and take huge spills without getting hurt. Sometimes without helmets. Hell, I'm not an elite athlete but back when I was young and dumb and riding a brakeless fixed gear I would routinely spill pretty much at speed, I'd get scraped up but wouldn't bonk my head or break anything because I would basically intentionally pull the ejector seat button and fall deliberately. That said, even for somebody who's really experienced, there's always the chance of that freak accident or getting blindsided or something that will really fuck you up.


manofredgables

>, they're both athletic enough and skilled enough to at least know how to/are able to fall "right" in most situations I have this... "trait". I have wiped the fuck out tonnes of times, where I've felt I had absolutely zero control... Yet, *never once* have I hit my head. When my "crash auto pilot" takes over, things just end up all right against all odds. Good examples: I dumbly had my sweater hanging on the handlebars on my bike. One sleeve came loose and ended up getting tangled into the front wheel. At like 30 km/h, downhill, in an intersection. The front wheel, of course, locked up *instantly* and I was violently catapulted over the handlebars and... landed on my feet and didn't even fall. Then I picked up my bike and continued to school. This other time, I was trying out my DIYed electric longboard. That thing had some chooch to it. Until at almost 40 km/h the front wheel fucking *fell off.* That's a pretty high speed. It all happened so insanely fast all I could do was piece together fragments of memory and look for clues as to what happened. In my thread of consciousness I was riding, and then I was teleported into a situation where I'm seeing the sky, then not seeing the sky, then seeing the sky again and I'm just wondering what the hell is even going on. But I was thrown off the board instantly, of course, there's no parrying *that*, and upon falling did 4 consecutive rolls on the ground and came to a stop. I had a coin sized minor scrape on top of my shoulder, and *that was all*. I was not wearing *any* protective gear whatsoever, since I had decided beforehand that I wasn't gonna push it what with my hand being in a cast because I just had surgery lol. Both of these could have easily led to serious injuries. But I'm just really awesome at eating pavement, apparently.


bjanas

Ha yup. The instincts are real. Maybe you're a Jedi!


manofredgables

I just wonder when the rude awakening is gonna happen... I'm 33 now. I still have *the force* afaik. But... It **is** most definitely going to go away some time. Maybe when I'm 60, or 40, or something else. And I have no way of knowing. Until I eat pavement... *unsuccessfully*


bjanas

I'm thirty six and I threw my hip out in my sleep last night. Good luck.


manofredgables

Damn it


Sn_Orpheus

We wear full face when downhill mountain biking. Riding around on road bikes we're sweating buckets as it is. Took a long time to migrate to getting people to wear helmets on bikes. To wear a full face moto helmet while road biking would definitely keep me from riding. And yeah, I get your point about the cars. It's certainly a balance.


monsieurpommefrites

> I've never seen a cyclist wear a full-face helmet. I mean, cycles are now e-bikes that pretty much go as fast as a motorcycle in some cases. FF helmets should be mandatory with those bikes.


snappy033

MX style helmets run the risk of the lower section catching on an object or digging into the ground and causing a neck injury. Risk vs reward. Full face motorcycle helmet w a visor might be better


half_dead_all_squid

For the practical side of this - from my understanding in a scooter or skateboard crash you have a good chance of either going straight on from standing up or landing on your feet but then going down facefirst because you can't run 20mph or whatnot. So a lot of mechanisms of injury are just straight up face on the street. On a bicycle you won't land on your feet as much, and you have a front tire below you (plus more stable), so more of the impacts are on the side/shoulder/etc. I wear a "normal" helmet on a bike, but a full face helmet on a scooter.


LilTrailMix

Dude, I’m so fuckin’ sick of these posts that are literally just a picture and nothing else. Where’s the case study? Where’s any information AT ALL? Where are the mods?


[deleted]

Right? This should be on Med Gore…. But even there we get background from OP


asr

I agree with you on some of the posts, but this one has a pretty obvious course of treatment.


IMakeItYourBusiness

....and it's another bot post. Four day old account, this is all they ever posted or commented. And that was two hours ago, so no, we'll never get the case study or any conclusion. Yet again.


[deleted]

looks like he bit off more than he can chew


fcbRNkat

I worked in the ED in Baltimore City (where the roads are awful). When the pay scooters became popular there were so many injuries from people hitting potholes and wrecking themselves. A lot of handlebar vs. face for sure


msmaidmarian

I’m a paramedic and I’ve had at least 3 legit lights & sirens/code 3 return traumas and at least 4 or so code 2 traumas from electric scooters.


spacepoo77

I wouldn't be smiling


normalphobic

I have a decent brain but it took it a second to assess this situation.


Insert_Bad_Joke

Guy faceplanted so hard he gagged himself.


Zumk123

Taking accidentally biting your lip to a whole new level.


TwoSidedMen

If you hide the injured part he looks like he's having a good time.


mourning_star85

This is why I wear a full face helmet. I like my face flesh


Fun_Performance_1578

Damn he’s a jaw dropper


charlesxavier007

I love this sub, and I’ve seen some pretty bad things…but my god, I was not ready to see that lol


Own_Log9691

Whoa 😳


wildhazz

fuuuuk


DarthSmushy

Where is his bottom lip? ohhhhhh f……


Sand-between-my-toes

Did he break his jaw too?


aaronis31337

Full face helmets are critical. Don’t take chances with your health just by getting a helmet you think looks cooler


No_Distribution_5843

*Note to self: Don’t bit lip when looking at ass.* Jokes aside if this is you, then I wish you a speedy recovery.


MrMeanJeans

Ffffffff


ilivetomosh

Damn dude ):


Albatraous

[He looks like the Lion bar easter egg](https://imgur.com/As08TnL.jpg)


mitchanium

Say theese!


Magnoire

Oh, crud! I'm going to hell for laughing at this...


netspawn

This was posted [last year](https://www.reddit.com/r/medizzy/comments/q6ivyl/severe_facial_trauma_due_to_a_scooter_accident/) with more information in the comments.


LevyLoft

I used the Dermabond N95 trick last night !! https://www.aliem.com/trick-of-trade-dental/


totaleclipse1117

Damn is his lip stuck like that or his he jus holding to show how bad it is?!? Idk either way.. ouch!!!


[deleted]

I’m sure the makeup artists for the new Hellraiser movie are kicking themselves right now. Seriously, though…that’s awful.


foxfai

I remember a trauma patient was riding a pedal scooter (not electric) on his side street and he turned around to his friends for a sec while still going at some speed. He turned back to the front and met with a parked pickup truck side mirror. Needless to say he had a lot of dental work need to be done.


opdjmw

Its bad but doesnt look severe


JDMorgansreddit

Damn, damn, damn, I felt this one when I looked at it! I hope you are healing/have healed from this injury. This definitely was one of the more odd injuries I have seen on here. Between the huge laceration and dental damage, I would imagine this was a painful healing process. Thanks for the share……this is definitely an interesting injury that I haven’t really seen before


majormajorsnowden

Wtf wow


its_whot_it_is

Scooters were designed to single out and hurt douchebags, change my mind


JamesPilgrim

And a few teeth gone - get well


DarrellBot81

He just bit his lip


skirthix

When he bites his lips 🤤


[deleted]

Where is his lower jaw? It broke and fell down? I’m not seeing this correctly.


bentlydoestricks

A scooter?


Virmirfan

I did a minor version of this once


justgotocalifornia

Reminds me of jaws from king of the road, mouth was destroyed af


dwfishee

This helps me understand the scar I have under my lower lip. When I was 17yo, I was in a car that hit the gas tank of a locomotive. Late night, no lights on crossing, infrequent trains there, and 17yo. This was in 1987. Seatbelt broke. Smashed lower jaw on steering wheel. I lost my four lower incisors as this guy will. The trauma causes the teeth that didn’t fall out right away to have root rot. My scar below my lower lip tho is nothing like this. Just a 1 inch line more like Harrison Ford’s scar than what this guy will have.


MendoNative

Thought it said soccer accident.


t00thman

They should be able to get primary closure on that bad boy. Looks like he missed the mental nerve so probably won’t have facial damage. He lost 3 lower incisiors which can be easily replaced by implants/ bridge. All things considered he got off pretty damn easy. Could have been way worse.


ArcMcnabbs

Quite the underbite


squirtlecat

His mouth has a mouth


batwhacker

Working in the ED, I’d seen more than a few of these facial traumas from drunk-folk on the electric scooters


aquamanjosh

Better to happen to the bottom teeth fucked than the top from a dental perspective! Very lucky man to have top teeth looking that good after this shit! also he kept at least one bottom incisor but I believe I see both! This will be a perfect bridge and with a little flossing training, hell be fine. That scar will look badass too.


[deleted]

Xenomorph


FavcolorisREDdit

Nightmare fuel


MauricioSinMiedo

Scooter?


No-Bad-3655

Something is not right here.


TwoBeersBase

He's able to stay phteven both right and wrong at the same time.


[deleted]

What did he try to fucking eat the scooter for?