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Elbow Fractures

How good are you at reading elbow X-rays? Here are some tools and rules that will help you pick up those elbow fractures. Fractures of the elbow usually fall into the following groups: CHILDREN: Supracondylar fractures ADULTS: Radial Head Fractures ELDERLY: Multiple Fractures Fractures are a CLINICAL Diagnosis. The x-ray merely confirms that you have found it….

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Hypothermia

Hypothermia is defined as any core temperature < 35 degrees Celsius Today I wanted to look at a case and then discuss the controversies associated with the Management of Hypothermia. CASE: An 87 year old woman is brought to your emergency department. She has been found unconscious in the street by a passer by. She…

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Hypernatraemia

CASE A 76 yo woman is sent in from the nursing home with myoclonic jerks. She has a past medical history of slight dementia and seizures. Her GCS is 13-14/15. On arrival she has constant myoclonic jerks. Initial Blood tests reveal the following: Na 165 K 3.6 Cl 112 U 12 Cr 112 You make…

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Maisonneuve Fracture

A Maisonneuve fracture is caused by pronation and external rotation. It can be difficult to find, even if we get fixated on the ankle. The patient may present with a complaint of rolling their ankle and ankle pain. Be vigilant for this type of injury. It is made of two main components: A spiral fracture of…

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A 9 year old girl with syncope

The Case A 9 yo girl is brought into the emergency department, following an episode of syncope. She has a current viral illness and looks miserable. She was walking into the Emergency Department with her mother, when she collapsed. She recovered quickly with no post ictal component but also had no memory of the event, although the…

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The Crashing Asthmatic Patient

The Crashing Asthmatic Patient is perhaps one of the most frightening of patients to treat. I’m not talking about the patient that has wheeze and gets five or six nebs and gets better in an hour. I’m talking about the sweaty, drowsy, tiring, non-responsive patient that you know has a good chance of dying. Here…

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Treating Patients on Stimulants

Here is a case, you are probably all familiar with: The police arrive with a patient that was “out of control”. He is known to take illicit substances. He went home earlier today, where he lives with his mother and ‘punched her in the face’, before running off. Police were called and he was later found naked,…

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The ECG of Athletes: Normal variations you must know.

The ECG of the athletes can pose a challenge in distinguishing pathological changes from those physiological changes, that are associated with physical training and cardiac remodelling. We don’t want to erroneously attribute heart disease to those with normal variants and more importantly, we don’t want potentially life threatening cardiac conditions being erroneously dismissed as normal…

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Passing the Fellowship MCQ Exam

How to pass the Fellowship MCQ Exam. That’s the question on everyones lips as we head towards the pointy end of studying for the exam. If you have never sat this exam before, let me tell you, the ACEM Fellowship exam, is a long day, so be rested. 3 hours of SAQ exam and 3…

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Hyponatremia

Hyponatremia is a common electrolyte abnormality. It can be acute or chronic. It can occur in isolation or as part of other disease processes.  Diagnosing its cause can be challenging in the Emergency Department and there may be some confusion over how to initially manage these patients. Let’s clear up that confusion, with a simple…

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