Snake Bite

Antivenom

This year at EMCORE 30-31st May, we are proud to have Dr Ken Winkel, Toxicologist and Director of the Australian Venom Research Unit at the University of Melbourne,  talking about cold blooded bites. Here is a recent article by Dr Winkel in The Conversation. The comments following the article are very worthy of a read. In [...]  Read More »

Reducing a Dislocated Jaw- A new way to do it.

TMJ Relocation1

Have you ever had to reduce a dislocated jaw? I’ve done about 3 and it is always tough. Either get in front or behind the patient and above the patient and with gauze over the gloved thumb of each hand, use intra-oral manipulation, which involves pushing down hard on the bottom molars and perhaps adding [...]  Read More »

Box Jellyfish stings: To vinegar or not?

Box Jellyfish

The call came: a case of Box Jellyfish(Chironex fleckeri) envenomation in a young girl and her father. The father was stable and pain was under control, however the daughter had such significant pain that, anti-venom had to be used. The wound had been washed with vinegar. Both patients were stable and comfortable in terms of pain levels. [...]  Read More »

Electrolytes and the Heart

Sodium

I was talking to a group of my junior registrars the other day about cardiac physiology, and I was struck by how much trouble they seemed to have relating electrolytes to the QRS complex. We sat down and nutted it all out which left everyone happy. The key to understanding the effects of electrolytes is [...]  Read More »

Magnesium Sulfate: Neuroprotective in Stroke? Study says no.

Neuroprotection

We have had a longstanding and controversial discussion about thrombolysis and definitive management of stroke, however, there is a unified front in trying to find a neuroprotective agent, that somehow shields the cells from damage. Over 70 different such agents have been tried in the past, with no success. One of the main criticisms relating [...]  Read More »

Supraventricular Tachycardia(SVT) in Infants

SVT

A mother brings her 7 month old son to the Emergency Department, as he has been irritable for the last 2 days.  There have been no major problems, apart from the irritability, that she can pinpoint, perhaps some slight feeding issues and some fever two days ago, but that is all. The local doctor had [...]  Read More »

The HEART Score for sorting Low Risk Chest Pain Patients

The HEART Score

The patient with chest pain is the most common presentation to Emergency Departments.  And certainly the low risk chest pain patients seem to take up a large degree of our resources, including time, laboratory testing, and follow up.  In the past, we’ve used scoring systems such as TIMI, PURSUIT and GRACE.  These scoring systems have [...]  Read More »

Thromboembolism in the Post-Partum Period

DVT

Patients presenting to the Emergency Department with signs or symptoms which might be indicative of a DVT or  pulmonary embolism in the postpartum period are treated with increased suspicion because there is in fact an increased risk. HOW LONG DOES THIS INCREASED RISK LAST FOR? The postpartum period is defined as 6 weeks following delivery.  [...]  Read More »

Chest Pain: How Sure Are We at Predicting?

Heart_Attack_Action_Plan_banner

Here’s a scary problem …. If I was a paramedic, not an emergency physician with all my resus cubicles, serial troponins and all the serum rhubarbs I could order and I was called out to see someone with chest pain, who would I take to the ED and who would I leave? The answer is [...]  Read More »

Priapism: How To Treat It.

I can fix it.

CASEA 46 year old man presented to our ED mid morning complaining of a persistent erection since 10pm the night before, when he had injected 20ml of alprostadil (“Caverject”) into his penis. He had not experienced any detumescence, and was quite distressed. We all know the solution to the problem – just drain the corpus [...]  Read More »