A new DAWN for stroke treatment
Last week we looked at a case study involving a patient who awoke with stroke symptoms. In these cases there has been little to offer patients. Thrombolysis has no application here, given its 3-4 hour window. Endovascular mechanical thrombectomy has been hailed as the new treatment. Until January of 2018, trials in this area demonstrated...
MCA Stroke management. It’s time for a rethink
Dealing with acute major vessel occlusion stroke in a peripheral hospital setting is not what it used to be. Nor should it be! This is a recent case from one of the team. This is a case of a 55 year old chef who woke up at 6am unable to speak or move the right...
Using Adrenaline the right way in Cardiac Resuscitation
ADRENALINE AND CARDIAC RESUSCITATION How much to use, when to use it and when not to use it. The resuscitation guidelines were born in the black-and-white television era, at the end of the 1950’s. The use of 1 mg of adrenaline which initially came from canine models, was introduced at this time and has been...
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...
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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