The following ECG was sent to me recently. It’s a great case and a situation that we can all be faced with. The question is: Is this VT or SVT with Aberrancy? The further question is; What do you do when your treatment isn’t working? An 80 year old male presents feeling unwell with palpitations....

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...

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...

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,...

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...

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...

Perimortem cesarian section is a rare and stressful procedure that must be performed in a timely fashion to give both the mother and foetus, the best chance for survival. Its rarity makes it something we must talk about, so that if any of us are faced with it, we know what to do. The fact that...

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...