A few people had a go. Well done! This is a tough one. This is my roundabout way of working it out. Probably not as slick as it should be but….it does the job. It IS a triple acid base abnormality and the diagnosis is probably salicylate toxicity. Sure the patient has a fever and [...] Read More »
Its the end of the week and those brain cells are slowing down a little, so here is a little diagnostic quiz for you. The feared blood gas! Now I know some of you say that I don’t do arterial gases any more, just venous, so I don’t need to worry about it………..common have a [...] Read More »
Is propofol the new wonder drug for treating headaches? You know the scenario: a patient comes in with headache for the previous few hours or even days. It’s the same as the patient’s normal migraine, but very severe and won’t go away. What do you do? A bit aspalgin and/or codeine and/or fluid and/or metoclopramide. [...] Read More »
Case Presentation: During a recent shift as a VMO in an Eastern State Regional ED I was faced with a rarely encountered, clinically important and emerging clinical challenge. Many of you would have noted the increase in media attention to the problem of tuberculosis, and particularly multi-drug resistant TB (MDR TB). 4 recent cases of [...] Read More »
…or how can I stop my sedated patient from desaturating? This is simple; a 7 minute video that briefly explains the use of apnoeic oxygenation. I use it to help keep saturations up in patients that I’m about to intubate, or in those that are sedated for a procedure. I use it in adults. It suits a patient [...] Read More »
Here’s an interesting idea. Using an application on your smartphone, as a holter monitor. The use of the smartphone in medical technology hasn’t really reached any sort of potential as yet, however we’re starting to see some great new apps. I have had paroxysmal atrial fibrillation, that has usually occured secondary to drinking more than [...] Read More »
Head injury in the anticoagulated patient can be a challenge. Below is the approach I use. I then read a 2012 paper from the Annals of Emergency Medicine, which gives us the evidence on what our approach might be. Here’s the scenario. A 56 yo male is brought to the emergency department following a mechanical [...] Read More »
Below is an ECG taken of a 0ne week old infant, who has some shortness of breath whilst feeding according to the parents. What does it show? Is it normal?ECG’s can already present a significant challenge, however there is a fear associated with the paeds ECG. There should not be, as the same principles that [...] Read More »
This week my good friend Dr Will Davies, Emergency Physician extraordinaire, adventurer and all round good guy and I talk about a case of eosinophilic myocarditis. Watch the video Read More »
WHICH TRAUMATIC ELBOW INJURIES SHOULD WE BE REFERRING FOR XRAY? I spend a considerable amount of my time working in remote environments where diagnostic resources are limited. This has led me to look for clinical decision aids to assist in the diagnoses of injury or illness without sending my patients for (often very distant) diagnostic [...] Read More »
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