CASE A 35 yo woman presents with a painful blue swollen leg, that occurred rapidly, the evening before. There is little relevant past history and the patient is on the oral contraceptive pill. Examination reveals a dusky, blue left leg, that is swollen in comparison to the other side. Pulses are present and the patient in neurologically...

Resuscitation is reaching new limits, with new techniques and technologies giving results that we never thought possible. In Lazarus-like fashion, patients that a few years ago, would have been pronounced deceased, are now leaving hospital to resume their lives, with their families and their work and with very little, if any, deficit. About 8 years ago I...

A 35 yo woman presents to the emergency department with a complaint of shoulder dislocation. There is a previous history of multiple dislocations, including two posterior dislocations. There has been no trauma, or seizure or other major force, as might be expected to cause a posterior dislocation, although posterior dislocation can occur in the absence...

The Case It was a quiet Sunday afternoon in a small ED (sounds like the start to a bad story, doesn’t it?) I picked up the next chart…30-year-old, 13/40, light PV bleeding History – otherwise healthy 30 year old, no medications, G2P1, 13/40, light bleeding since yesterday, some cramping low abdominal pain, USS at 10/40...

If you haven’t caught the newly published Paramedic-2  trial, here’s a brief rant that tells you everything you need to know. The ostensible reason for the publication has been the ongoing debate about the role of adrenaline in cardiac arrest. In fact the very first line of the paper reads “concerns about the use of...

A 58 yo male presents to the emergency department with an 8 hour history of diplopia. He has no past medical history, has no allergies and is on no medications. He denies any recent illness or trauma. Recently a great journal article was brought to my attention and I thought everyone should hear about it....