The Next Fellowship Course starts August 15th

Don’t miss out on the next 6 month Fellowship Course. We start on August 15th and go for 6 months, plus two lots of face to face teaching. To take the tour, just click here.  Read More »

Predicting The Fellowship Exam

exam_poster

Every year, I give my predictions of the top questions for the Fellowship Exam. Usually, my hit rate is good. One of my students recently said, “I should have just studied your top 30 list”. I don’t recommend this, but here is another year’s predictions. The predictions are based on: Questions that have been asked [...]  Read More »

Management of DKA in Children

4ts od Type 1 DM

CEREBRAL OEDEMA: DO WE REALLY KNOW THE CAUSE? We recently had a child with DKA in our department and the subject of fluid resuscitation came up. Also the Queensland Government guidelines on the Emergency Management of children with DKA has recently been produced. I thought it was timely to revisit a blog I wrote in [...]  Read More »

Should We Lower BP in Inra-Cerebral Haemorrhage- ATACH-2

ICH

Two days after speaking at the EMCORE Conference on blood pressure control in intra-cerebral bleeds the ATACH-2 trial (Antihypertensive Treatment of Acute Cerebral Haemorrhage II) has been published. We know that intra-cerebral bleeds are dynamic, with up to 40% of patients having growth in haemorrhage volume, in the first 3 hours(Stroke 1997:28:1-5). We also know [...]  Read More »

The Penumbra Conundrum

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…or How to Control Blood Pressure in Brain Bleeds The scenario is this:A 62 year old male is brought in to your emergency department by ambulance. He has had a sudden onset of headache and has decreased use of left side. His vitals are:GCS 14, HR 92, BP 210/100, Sats 95% on room air. A [...]  Read More »

5 Things To Help You Get The Airway

endotracheal tube

1. Know When To Intubate It may sound strange, but we should have an approach as to when it’s appropriate to intubate. My choice is when there is failure of ( whether this is now or imminent) of oxygenation and ventilation, maintenance of airway or airway protection. I then also ask the questions:1. Will I [...]  Read More »

Scapholunate Dissociation

Scapholunate dissociation

The typical case is a patient presents with trauma to the wrist and wrist pain. You do an x-ray. What do you think? This is a Scapholunate dissociation, also called rotatory subluxation of the scaphoid and sometimes knows as the Terry Thomas sign. It is a disruption of the scapholunate ligament with resultant instability. The [...]  Read More »