“Visión de túnel”/ Tunnel vision

Clinical case

• An 65 years old man went to the hospital with cough and hemoptisis. An X-Ray showed a pulmonary image compatible with lung cancer.

• The patient stayed at the hospital for bronchoscopy and the doctor wrote that he was also having strong foot pain.

• 24 hours later arterial ischemia was detected and the patient suffered an intervention but with bad outcome.

Case analysis

• Tunnel vision: the doctor didn,t paid enough attention to foot pain, because the image at the lung keep all his efforts. This concept is closely related to “premature closing” because the incomplete evaluation of data of the patient.

• Bad communication, specialization and incomplete clinical evaluation, are at the base of this situation.

Etiology and clinical examination

Foot pain

Foot pain

•Muscles and bones.

•Neurogénic.

•Vascular.

DOLOR PIE

• Muscle and bones: hyperuricemia

Foot Pain

• Neurogénic: Diabetic neuropathy

Foot Pain

• Vascular: celulitis, Deep Venous thrombosis, arterial ischemia.

Pedial pulse

Tibial pulse

Popliteal pulse