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 »

Back-stabbing: A case of Brown-Sequard Syndrome

Stab wound to the back

Introduction Brown-Sequard syndrome is one of those cases that we are all aware of, have studied for exams and have pondered the anatomy of, but few have ever seen. First noted by Charles-Édouard Brown-Séquard in 1851 who, despite having some rather eccentric ideas about sexual prowess and the eating of primate testes, was a renowned [...]  Read More »

The Crashing Atrial Fibrillation Patient: Part 1

Crashing Atrial Fibrillation Patient

You know this patient. You’ve probably seen a patient, just like this. They are old, they have rapid atrial fibrillation(AF) and their blood pressure is sinking to their boots. What do you do? Let’s look at a case we had recently. Case An 82 year old male with a past medical history of hypertension and [...]  Read More »

Diagnosis of Scaphoid Fractures

Scaphoid Fracture

Here is the case You have a 24 year old, right-handed tradesman, with who fell over playing football on the weekend. He has injured his right wrist, he has tenderness over distal radius and snuff box and his initial x-ray series is normal. What next? This blog contains the short answers, and the longer answers [...]  Read More »

Pseudo-Wellens’ Syndrome


I recently saw post-op patient sent down to the ED (no ICU at this hospital- ED takes care of everything really sick), who had some T wave changes in her anterior leads and had complained of chest pain, which was relieved with anginine. The medical registrar’s plan was serial ECGs and troponins and if normal [...]  Read More »

Aschner Phenomenon in Traumatic Enucleation of the Eye


Introduction Aschner phenomenon or oculocardiac reflex is characterised by an episode of dramatic bradycardia following manipulation of extra-ocular muscles or dramatically raised intraocular pressure. The phenomenon was first described by Aschner and independently by Dagnini in 1908 (1,2). The phenomenon is well recognised in the fields of ophthalmic surgery and anaesthesia, but few cases exist [...]  Read More »