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Archive for April 2016

The Penumbra Conundrum: Intracranial Haemorrhage

How to Control Blood Pressure in Intracranial Haemorrhage The scenario is this: A 62 year old male is brought in to your emergency department by ambulance. He has had a sudden onset of headache and has decreased use of left side. His vitals are: GCS 14, HR 92, BP 210/100, Sats 95% on room air. A CT…

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5 Things To Help You Get The Airway

1. Know When To Intubate The Advanced Airway is not just about doing, but also about thinking. It may sound strange, but we should have an approach that allows us to quickly ascertain the appropriateness of intubation. My choice is when there is failure of ( whether this is now or imminent) of oxygenation and…

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Scapholunate Dissociation

Introduction Scapholunate dissociation, also called rotatory subluxation of the scaphoid and sometimes also known as the Terry Thomas sign. It involves a disruption of the scapholunate ligament resulting in instability. The scapholunate ligament is U shaped and divided into three compartments. A complete fear of the dorsal part, results in dissociation. The cause is usually trauma,…

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Thoracic Aortic Dissection: 5 things to make the diagnosis

CASE A 70 year old man, is brought to the Emergency Department by ambulance. He was drinking a coffee with friends and developed sudden severe chest pain. His past medical history is coronary artery disease and hypertension. He became hypotensive in the ambulance and was in some distress. He has had a bolus of fluid…

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The ECG of Pulmonary Embolism

There are several distinct ECG patterns in pulmonary embolism A CASE A 36 yo male presents to the emergency department with sharp central chest pain and shortness of breath. He works as a truck driver. He has no past medical history, is on no medications and normally very well, with no significant family history. An ECG…

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