How Big is that Pneumothorax?

Pneumothorax size

Can you easily calculate the size of a pneumothorax? Does the size matter? Calculating the size has been difficult, as it requires formulas we don’t necessarily carry around in our heads; like the figure on the left. In most cases we approximate and say it’s about such and such a percent. I know in many [...]  Read More »

The Deep Sulcus Sign and more.

image from learning radiology

Have you ever had a chest X-ray in someone that might have a pneumothorax, but you couldn’t see it? I know I have. Today I wanted to mention three signs that might help: The first is the Deep Sulcus Sign. This is the more widely known. The other two signs are the Etched Diaphragm and [...]  Read More »

DKA and Cerebral Oedema – Do we really know the cause?

Osmolytes

Cerebral oedema is the most feared complication in children presenting with Diabetic Ketoacidosis (DKA). It occurs in about 1% of cases but has a mortality rate of up to 90% (Waldorf J et al Diabetes Care 2006; 29:1150-9). Patients will have a decreased conscious state and may also have cranial nerve palsies, headache and/or bradycardia [...]  Read More »

The ECG’s of Syncope

Causes of Syncope

I’m not sure about you, but I seem to be seeing more patients with syncope than ever before. This year at EMCORE, I spent over an hour going into the ECG’s of syncope. Syncope is difficult because it is a symptom, not a condition and it’s up to us to find the cause. My approach [...]  Read More »

Delayed Sequence Intubation

Superdoc

There’s been a lot of talk around about Delayed Sequence Intubation and a little bit of confusion about it, so I thought I’d clear up a couple of things. Is there a lot of evidence for it? No- there is very little, but we will see the evidence coming out soon. The current evidence is [...]  Read More »

3 Essential things to do to get the Airway

Obese Patient Positioning

Well, I’m now writting the lectures for the EMCORE Conferences for Hong Kong,  Melbourne and Fiji and I was quite excited about this content and wanted to share some of it with you. Today I wanted to spend a little time talking about one of the three things I’ll be discussing at the EMCORE. This is point 2, of the 3 [...]  Read More »

‘A Doctor’s Touch’

Dr Abraham Verghese

Who are you inspired by in Medicine? My clinical heroes are certainly the classics: William Osler and Hamilton Bailey. Last night whilst working a busy shift, I was reminded(whilst performing a clinical examination on a patient, that gave us the answer to what was wrong, when nothing else made sense) of the power of the [...]  Read More »

The Crashing Atrial Fibrillation Patient- Part 2- What inotrope to use?

Frank Starling Curves

Let me remind you of the patient we had in part 1 of this blog. The patient had presented in rapid atrial fibrillation at a rate of 170-180.  His BP was about 60mmHg systolic. Cardioversion was attempted( x 3) with Metaraminol used to support blood pressure, however it was unsuccessful. An Amiodarone infusion was commenced [...]  Read More »

Bilateral Hemianopia in Pregnancy

Screen Shot 2014-02-09 at 4.12.45 pm

Here’s the Case A 31 year old female patient at term P2G1, had noticed tunnel vision whilst watching her children in the garden. Soon after this she developed a bi-temporal headache. No other symptoms were present. The only past medical history was of a hearing impairment and hypertension early in the pregnancy. The clinical examination [...]  Read More »

The Many Faces of Tuberculosis

The many faces of TB

    As many of you who regularly read this blog will know, I have a bit of a thing for TB. I hate it. It offends me. I am frustrated that a disease that was thought to be on its way to eradication a generation ago has fought back and we may soon find [...]  Read More »