Intraosseous Access Results In Decreased Survival In Cardiac Arrest
A new study shows a decreased survival in out of hospital cardiac arrest(OHCA) when intraosseous(I/O) access is used instead if intravenous(IV) access as a means of delivering fluids and medications. I/O lines provide rapid access where IV is not available and are progressively being used as the first line of access, primarily because they are quick, easy, don’t interfere...
Paediatric Heart Conditions You MUST KNOW
Congenital heart conditions present at birth, but can also present within the first month of life. We look at a simplified approach to the assessment and management of patients presenting with symptoms of congenital heart disease. In this video Dr Claire Wilkins, talks about these conditions and spits them into three categories: Patients presenting with SHOCK...
Myocarditis
Myocarditis is simply an inflammation of the heart muscle, that can lead to myocardial cell damage, myocardial dysfunction and heart failure. A Recent Case A 15 yo male presents to the emergency department with sharp central chest pain that is worst on inspiration. The pain has woken him from sleep. There is no radiation although...
Should We Shock Patients in Asystole?
Should cardiac arrest patients in asystole be shocked? Is there any advantage to this? What do we know about asystole in cardiac arrest? Patients in asystole are known to have a very poor prognosis, with 0% to 2% surviving to hospital discharge. There is a slightly better prognosis if the rhythm converts spontaneously to a shockable rhythm...
Fever in the ED
Fever In The Emergency Department We like to see things as binary in the ED, troponins, d-dimers, CTPA they all give yes no answers. We often treat fever in a similar way, fever = infection just like our mothers taught us. But are we any better than a hand on the forehead, can we use temperature...
Syncope Rules
Patients presenting with syncope to the Emergency Department can pose a significant diagnostic challenge. The two main reasons for this are: Syncope is a symptom, not a diagnosis. We need to search for the underlying cause. Adverse events can occur, when none are obvious or predictable during our Emergency Department evaluation. We know that the rate...
Diagnosing Ventricular Tachycardia in 5 easy steps
Here is a simple case of potential ventricular tachycardia(VT) How do you manage this? A patient has been brought into your resuscitation cubicle with the a complaint of palpitations. His ECG is as follows: The patient is obviously unstable, so the management decision is easy: ELECTRICITY. What if the patient is stable with a BP...
EMCORE FIJI
2-4 October
EMCORE Santorini
25-27 October
How long do we have, to pick up that an ECG is abnormal? Usually it’s about 20 seconds. I developed ‘The ECG in 20 Seconds Approach‘, a simple method, to help you read ECG’s.
Head Thrust Test
In a patient with rotational vertigo and nystagmus, where we suspect, or wish to prove a peripheral lesion, this test is of assistance. It relies on the vestibulo-occular reflex, which is responsible for bringing the eyes back to the centre.
In unilateral nystagmus and rotational vertigo, the peripheral lesion is opposite to the direction of the fast nystagmus. When the head is turned towards the lesion, the eyes move with the head, for a brief moment and the vestibular-occular reflex then returns them to the centre. If this occurs it is a positive test indicating a peripheral cause.
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