HOW OFTEN DO THEY OCCUR?
They can occur in up to 25% of patients with head injuries.
WHERE IS THE FRACTURE?
There are several possible fractures that can occur in the skull. Basilar fractures are most commonly longitudinal fractures of the petrous temporal bone and may involve the external auditory canal and tympanic membrane.
SYMPTOMS AND SIGNS
Battle’s Sign- This [...]
A 24 year old male presents following a syncopal episode. On cardiovascular examination you believe there is a systolic murmur. Given his history and a family history of his father having a ‘large’ heart, you are suspicious of cardiomyopathy. How can you assess on clinical examination if the murmur is that of cardiomyopathy?
I know most [...]
As I sit here, after a fantastic Christmas day and I think of all the things I’m grateful for, in this last 12 months, I write to thank you all for your continued committment to excellence and learning.
I thank you for the opportunity to teach and for the time you give to read the blogs [...]
Hi everyone. I wanted to spend a few moments on supracondylar fractures in children as this is one fracture that seems to be missed, when it’s not obvious and when first reading the Xray.
It’s actually a pretty straightforward view of the elbow joint. The only catch is that the elbow must be at right angles [...]
Hi all. This is a case from a few days ago. I loved it, as it was one of those slam dunk diagnosis, even when everything looked normal, thanks to the ECG.
A 63 year old woman presents with sudden onset of shortness of breath. It began, whilst she was in the supermarket, shopping. The shortness [...]
Good clinical examination is so important in what we do. I say, just have a look, sometimes you’ll be surprised what you pick up.
In this month’s NEJM‘s image challenge, this image was presented.
Where is the lesion?
Is it:
(a) Left facial nerve
(b) Left glossopharyngeal nerve
(c) Left hypoglossal nerve
(d) Right glossopharyngeal nerve
(e) Right hypoglossal nerve
The answer is…………
….left hypoglossal [...]
I recently ran another of our Advanced Airway Workshops at ACEM’s 2011 ASM and invited the guys from Verathon, to bring in the Glidescope and let people have a play with it. I hope they will be at our June Airway workshop in 2012 as part of the EM CORE Conference. ( I have no financial [...]
Left Ventricular Hypertrophy(LVH) can cause all sorts of problems in terms of ECG diagnosis. There is a straightforward and simple approach to diagnosing it. Here is the ECG in 20 Seconds Approach.
The criteria for diagnosing LVH are very specific(>90%) but not sensitive(50%). That means that if the criteria are met, it’s probably there. If not, then it may still be [...]
STUDY 1
THE CIRC TRIAL
This is a Zoll funded study that looks at Zoll’s ‘autopulse’.
I reviewed the autopulse back in 2007.
The study commenced in 2007 and had a total of 4231 patients recruited.
The results were just presented at the American Heart Association’s, Resuscitation Science Symposium.
The results reported, were that the autopulse is equivalent to high quality [...]
Hi Everyone
Just finished a great week at the ASM 2011 conference, in Sydney. Thanks to all the people that came up and said “Hi”.
One of the talks I gave was on “Guidelines Schmidelines”. A lot of people came up after the talk and asked if I could write it up.
So here it is.
AIRWAY
I was specifically [...]
