The Next Fellowship Written Exam Starts Feb 29th

The next 6 month Emergency Fellowship Exam Course starts February 29th 2016. This is 6 months of Virtual teaching and 4 days of face to face teaching! We have approximately 4 places left. Book Now. Read more about the course HERE.  Read More »

The Shock Index

Shock Index

The Shock Index. Do you use it? Do you know what it is? Originally it was used to predict shock in medical patients in the Emergency Department, but since then has been evaluated for use in trauma and myocardial infarction.Although it’s been around for over 50 years it’s doesn’t appear to be widely used in [...]  Read More »

New venous thromboembolism treatment guidelines


The American College of Chest Physicians has just produced a treatment guideline for venous thromboembolism(VTE) and Pulmonary Embolism(PE). The primary push in this guideline is for the use of non-vitamin K oral anticoagulants over warfarin. Here is a brief summary DEEP VENOUS THROMBOSIS (DVT) Isolated DVT with no severe symptoms or risk factors: suggest serial [...]  Read More »

Continuous vs Interrupted CPR for Survival


A new paper by the Resuscitation Outcomes Consortium (ROC) was published in the NEJM(November 9th 2015). Nichol et al looked at Trial of Continuous or Interrupted Chest Compressions during CPR and their effect on survival. This was a prospective randomised crossover trial of  26148 patients in the pre-hospital environment. In the test group, CPR was performed [...]  Read More »

Beware the ECG mimic


You have a patient in the emergency department with a history of high fevers and cough. He is initially, very dehydrated, tachycardia and hypoxic on room air. The nurse calls you and says that the patient is going into ventricular tachycardia(VT). His ECG is as below.What do you do now? Scroll down for the answer… [...]  Read More »


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It occurs in about 0.3% of the population (1), although this is an underestimate, as evidence of pre-excitation on the ECG my be transient.  The characteristic delta wave indicates that the accessory pathway conducts faster than the Atrioventricular (AV) node, thus resulting in pre-excitation. However, the refractory period of the accessory pathway may change meaning [...]  Read More »

The New Paracetamol Guidelines

Paracetamol guidelines

We have an update on the Management of Paracetamol Poisonings (MJA 203(5). 7 September 2015) (last update was in 2008) and it covers six main areas: Risk Assessment Charcoal Use Modified Release Paracetamol Large/Massive Ingestions Liquid paracetamol in children less than 6 years old. Consulting a Liver Transplant Unit Some Notes: In children less than 6 [...]  Read More »